About the Company
UnitedHealthcare, a part of the UnitedHealth Group family of businesses, is a leading health benefits company dedicated to helping people live healthier lives and making the health system work better for everyone. We serve millions of individuals and employers with a comprehensive range of health care products and services. Our commitment to innovation and patient-centered care drives us to build a healthier future.
Job Description
We are seeking an experienced and compassionate Case Management Registered Nurse to join our dedicated team. This is a 100% Work From Home (WFH) role, offering you the flexibility to manage your caseload from anywhere. As a Case Management RN, you will play a critical role in assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet an individual’s health needs. You will advocate for our members, ensuring they receive appropriate, cost-effective care and support through a collaborative process. This position requires strong clinical judgment, excellent communication skills, and a proactive approach to care coordination within an insurance company framework.
Key Responsibilities
- Conduct comprehensive assessments of members' health needs, including physical, psychosocial, and environmental factors.
- Develop individualized care plans in collaboration with members, families, and healthcare providers.
- Coordinate access to appropriate medical services, community resources, and support systems.
- Educate members on their health conditions, treatment options, and benefits.
- Monitor members' progress and adjust care plans as necessary to optimize outcomes.
- Facilitate communication between members, providers, and other stakeholders.
- Document all case management activities accurately and timely in the electronic health record.
- Adhere to all regulatory guidelines, company policies, and ethical standards.
- Identify potential barriers to care and develop strategies to overcome them.
- Participate in interdisciplinary team meetings and clinical rounds.
Required Skills
- Active, unrestricted Registered Nurse (RN) license in California (or ability to obtain).
- Minimum of 3 years of clinical experience as a Registered Nurse.
- Minimum of 2 years of experience in case management, care coordination, or utilization review within an insurance or managed care setting.
- Proficiency with electronic health records (EHR) and Microsoft Office Suite.
- Strong critical thinking, problem-solving, and decision-making abilities.
- Excellent verbal and written communication skills.
- Ability to work independently and manage a diverse caseload effectively.
- Demonstrated ability to maintain confidentiality and professionalism.
Preferred Qualifications
- Bachelor of Science in Nursing (BSN).
- Certified Case Manager (CCM) certification.
- Experience with telephonic case management.
- Knowledge of local and national healthcare resources and regulations.
- Bilingual skills (e.g., Spanish, Mandarin).
Perks & Benefits
- Comprehensive health, dental, and vision insurance plans.
- Paid time off and company holidays.
- 401(k) retirement plan with company match.
- Life insurance and disability benefits.
- Employee assistance program.
- Opportunities for professional development and continuing education.
- Flexible spending accounts (FSAs) and health savings accounts (HSAs).
- 100% remote work flexibility.
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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