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Senior RN Complex Case Manager - Optum NV
UnitedHealth Group Las Vegas, NV
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$87k-104k (estimate)
Full Time | Insurance 2 Months Ago
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UnitedHealth Group is Hiring a Senior RN Complex Case Manager - Optum NV Near Las Vegas, NV

$10,000 Sign-On Bonus for External Candidates

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. 

The Senior Case Manager will identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members. 

Primary Responsibilities: 

  • Applies motivational interviewing in identifying impact on member engagement and setting goals
  • Member education, medication reconciliation and benefit management
  • Ensures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan and community
  • Facilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as needed
  • Ensures coordinated services delivered and available programs are accessed
  • Communicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient care
  • Utilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient care
  • Identified point of contact for managing transitions of care

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. 

Years of post-high school education can be substituted/is equivalent to years of experience

Required Qualifications: 

  • Current, unrestricted NV RN license
  • 3 years of direct patient care nursing with a focus on discharge planning or case management
  • Proven knowledge of UM and plan benefit designs
  • Proven knowledge of Utilization review and MCG 
  • Competent with MS Office and other practice management systems or possess the ability to continue to learn new things
  • Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area

Preferred Qualifications: 

  • CCM certification
  • Solid clinical knowledge and capacity for continued learning
  • Proficient in critical thinking skills of RN Case manager
  • Proven ability to organize and prioritize tasks for self and patients
  • Proven solid verbal and written communication skills
  • Ability to perform case management activities

Nevada Residents Only: The salary range for Nevada residents is $70,200 to $137,800 annually. 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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 

Job Summary

JOB TYPE

Full Time

INDUSTRY

Insurance

SALARY

$87k-104k (estimate)

POST DATE

02/23/2024

EXPIRATION DATE

06/11/2024

WEBSITE

unitedhealthgroup.com

HEADQUARTERS

THREE BRIDGES, NJ

SIZE

>50,000

FOUNDED

1980

INDUSTRY

Insurance

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About UnitedHealth Group

Our mission is to help people live healthier lives and to help make the health system work better for everyone. A Fortune 6 company, we're focused on helping people live healthier lives while making the health system work better for everyone. Here, we seek to empower people with the information, guidance and tools to make personal health choices. We work harder and we aim higher. We expect more from ourselves and each other. And, at the end of the day, were doing a lot of good for more than 142 million people worldwide. Our biggest point of differentiation is our people - and the collective ta...lent, energy, intelligence and drive our force of 305,000 individuals around the world bring to our mission every single day. So, how do we do it? With our every action, interaction and intention that demonstrates the five fundamental values that guide everything we do: Integrity Compassion Relationships Innovation Performance If you're looking for a place where your drive, compassion and passion can make a difference in the health and well-being of others, consider UnitedHealth Group. Click below to search careers or join our social communities: Search and apply for careers at: http://careers.unitedhealthgroup.com Like us on Facebook at: http://www.facebook.com/uhgcareers Follow us on Twitter at: http://www.twitter.com/uhgcareers Diversity creates a healthier atmosphere: 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. More
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