Title: RN Case Manager - Tonawanda, NY
Location: US-NY-Tonawanda
Job Number: 512239
Want to learn more before applying for this role? Click here to view the Realistic Job Preview:Telephonic_Case_Manager_Optum.pdf
This position is located in our Tonawanda, NY office
11 AM - 8 PM Shift, Monday - Friday, No weekends or Holidays!
Primary responsibilities:
* 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
* Make transitional care calls to ensure that discharged member receive the necessary services and resources
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.
If you want more meaning in your career - as a clinician or a business professional - think of OptumHealth as your calling.
By providing 58 million Americans with information, tools and solutions, we are helping to guide them through the health care system, financing their health care needs, and enabling them to achieve their personal health and well-being goals.
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.
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.
Qualifications:
* Current, unrestricted RN license in NY
* 3 years experience in a hospital setting, acute care, direct care experience, home care and/or experience as a telephonic Case Manager
* Computer proficiency including the ability to type and talk at the same time and to navigate a Windows environment (Word and Excel)
Additional Assets Preferred:
* BSN
* A Background in managed care
* Certified Case Manager (CCM)
* Bilingual in Spanish
* Experience with maternal health
* Experience /exposure with discharge planning
* Experience in utilization review, concurrent review and/or risk management
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.
Job: Case Management
