About the Company
UnitedHealth Group is a diversified health and well-being company dedicated to helping people live healthier lives and helping make the health system work better for everyone. We serve millions of individuals and provide a broad spectrum of products and services through two distinct platforms: Optum and UnitedHealthcare. Our commitment to innovation and care transformation drives us forward, always with a focus on improving health outcomes and access to quality care.
Job Description
We are seeking a highly motivated and experienced Registered Nurse (RN) Case Manager to join our remote team. This is a crucial role responsible for coordinating the care of members with complex health needs, ensuring they receive appropriate, high-quality, and cost-effective care. The ideal candidate will leverage their clinical expertise, communication skills, and knowledge of healthcare systems to advocate for members and facilitate comprehensive care plans. This position is 100% remote, allowing you to work from anywhere in the USA, provided you have a suitable home office environment.
Key Responsibilities
- Conduct comprehensive assessments of members' health needs, including physical, psychosocial, and environmental factors.
- Develop, implement, monitor, and evaluate individualized care plans in collaboration with members, their families, and healthcare providers.
- Coordinate and facilitate access to necessary healthcare services, including medical appointments, home health, durable medical equipment, and community resources.
- Educate members and families on health conditions, medication management, self-care strategies, and preventive care.
- Communicate effectively with interdisciplinary team members, physicians, payers, and external agencies to ensure continuity of care.
- Identify and address barriers to care, such as social determinants of health, and provide appropriate interventions or referrals.
- Maintain accurate and timely documentation of all case management activities in accordance with company policies and regulatory requirements.
- Participate in quality improvement initiatives and adhere to all ethical and professional standards of nursing practice.
Required Skills
- Active, unrestricted Registered Nurse (RN) license in at least one state with the ability to obtain licensure in multiple states as required.
- Minimum of 3 years of clinical experience as a Registered Nurse in an acute care, home health, or managed care setting.
- Strong understanding of case management principles and processes.
- Excellent verbal and written communication skills, with the ability to build rapport with diverse populations.
- Proficiency in using electronic health records (EHR) and case management software.
- Ability to work independently, prioritize tasks, and manage a caseload effectively in a remote environment.
- Critical thinking and problem-solving abilities.
Preferred Qualifications
- Bachelor of Science in Nursing (BSN) degree.
- Certification in Case Management (CCM).
- Experience with telephonic case management.
- Knowledge of managed care regulations and guidelines.
- Bilingual skills (e.g., Spanish/English).
Perks & Benefits
- Comprehensive medical, dental, and vision insurance plans.
- 401(k) retirement savings plan with company match.
- Generous paid time off (PTO) and holidays.
- Tuition reimbursement program for continuing education.
- Employee wellness programs and resources.
- Life insurance and disability coverage.
- Employee assistance program (EAP).
- Opportunities for professional development and career growth.
- Flexible work schedule in a 100% remote setting.
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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