$10,000 Sign-on bonus for External Candidates

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The primary responsibility for case management includes utilization management of hospitalized health plan members, care coordination, improved transitions of care and discharge planning. Ensure patients receive quality medical care in the most appropriate setting. Performs the following case management on a daily basis: 1) patient assessment of all major domains using evidence-based criteria (physical, functional, financial and psychosocial); 2) develop individualized discharge plans that involve provider, patient and caregiver goals for successful transitions of care; 3) implement discharge plan involving health care resources across the continuum; and 4) monitor and report variances that may challenge timely quality care or care progression.

**Candidates must be flexible to work onsite at a hospital in the Las Vegas and Henderson area**

Primary Responsibilities: 

• Assess and create a discharge plan to ensure patient receives quality medical care. Implement care strategies that are individualized for patients and directed toward the most appropriate and the least restrictive level of care
• Utilize both company and community-based resources to establish a safe and effective case management plan for hospitalized members and effective discharge planning to prevent readmissions
• Collaborate with patient, family, and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge plan
• Communicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided timely to all hospitalized members
• Advocate for patients and families as needed to ensure the patient’s needs and choices are represented and supported by the health care team
• Utilize approved clinical criteria (MCG and/or InterQual) to assess and determine appropriate level of care for hospitalized members
• Utilize approved insurance products, benefits, coverage limitations, insurance, and governmental regulations as it applies to the health plan
• Accountable to understand role and its effect on utilization management benchmarks and quality outcomes
• Work performed and completed onsite at various acute and alternative level of care facilities within the area
• Floating may require covering bases in another facility telephonically

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. 

Required Qualifications: 

• Registered Nurse with active unrestricted license in the state of Nevada
• 2 years of varied clinical experience in a hospital setting with an emphasis on case management or utilization management
• Possess knowledge of utilization management in a managed care environment. Understand spectrum of alternate delivery system
• Basic to intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word
• Demonstrate initiative toward problem solving without direct supervision
• Must possess a valid Nevada driver’s license and maintain personal auto insurance coverage
• Willing and able to travel 75% /- depending on business need 
• Reside within commutable distance to Las Vegas, NV

Preferred Qualification:

• Certified Case Manager (CCM) within 2 years of employment 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

Nevada Residents Only: The hourly range for this role is $28.03 to $54.95 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. 

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.