Job: In office Telephonic Case Manager RN with OptumHealth in Greensboro, NC

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Jobing Description

In office telephonic Case Manager / Disease Management RN Nurse roles with OptumHealth in Greensboro, NC.


Want to learn more before applying for this role? Click here to view the Realistic Job Preview: Telephonic_Case_Manager_Optum.pdf




As a Case Manager, you will be responsible for clinical operations and medical management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating. This may include case management, disease management, coordination of care and medical management consulting. You will also be responsible for providing health education, coaching and treatment decision support for members. Case Managers work in a variety of settings: in the community providing proactive care coordination to individuals and support to their families or in telephonic care management position.


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

Making "welcome home" calls to ensure that discharged member receive the necessary services and resources

Skills / Requirements

Qualifications:

Current, unrestricted RN license in the State of North Carolina

2+ years experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company

Computer proficiency including the ability to type and talk at the same time and to navigate a Windows environment

Ability to work 1-2 nights monthly until 8:00 PM required.

Additional Assets Preferred:

BSN

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.