Case Management RN Maryland Heights, MO (511011)
UnitedHealth Group - Maryland Heights, MO

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Responsibilities for Case Managers include :
  • Making outbound calls to assess members' current health status
  • Identifying gaps or barriers in treatment plans
  • Providing patient education to assist with self management
  • Interacting with Medical Directors on challenging cases
  • Coordinating care for members
  • Making referrals to outside sources
  • Coordinating services as needed (home health, DME, etc)
  • Educating members on disease processes
  • Encouraging members to make healthy lifestyle changes
  • Documenting and tracking findings
  • Utilizing Milliman criteria to determine if patients are in the correct hospital setting
  • Making 'welcome home' calls to ensure that discharged member receive the necessary services and resources
What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

To perform heart failure telephonic case management for our Medicare & Retirement population.

Requirements

Requirements:
  • Current, unrestricted RN license in the State
  • 2+ years experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
  • Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment
Additional Assets Preferred:
  • Bachelor's Degree
  • A background in managed care
  • Case Management experience
  • Certified Case Manager (CCM)
  • Experience/exposure with discharge planning
  • Experience in utilization review, concurrent review and/or risk management
  • Strong organizational skills and multitasking abilities will be keys to success
OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

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