Ontario - CA Full Time 2 weeks ago

***5K Sign-On bonus for external candidates only*** ***Local Telecommute***

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making health care data available wherever and whenever people need it, safely and reliably. There’s no room for error. Join us and start doing your life’s best work.(sm)

The RN Care Manager will be a member of the Chronic Care Case Management team coordinating comprehensive health care services in a cost-effective manner while assuring that quality is maintained for our senior members. A medical/social model will be used in the coordination of care. This position will report to Manager of Case Management.

Primary Responsibilities:

  • Supports the vision and direction of the company and medical management department
  • Using professional judgment and critical thinking skills will complete disease specific health appraisals/risk assessments
  • Collaborates with attending physician, medical director, care partner, and team social worker to identify problems and develop a member specific plan of care
  • Obtains plan benefits and established plan of care based on benefit design
  • Channels health care services to contracted providers and seeks approval for coordination of out of network services when medically necessary
  • Serves as a patient advocate
  • Assists member and family in meeting their informational needs related to disease process, health plan, and opportunities for community support
  • Develops and maintains in conjunction with the social worker local community resources by geographic area
  • Participates in policy and procedure development, QI projects, and other job duties as necessary
  • Other duties as assigned

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.

Required Qualifications:

  • Diploma in Nursing or higher
  • Current, unrestricted CA RN License
  • 2+ years in clinical nursing experience
  • 1+ years of experience in case management
  • Have acute or ambulatory care experience in managing cardiac, pulmonary, renal and diabetes disease states
  • Experienced with managed care regulations and Medicare
  • Ability to develop innovative approaches in delivering health care and social services to assist members in maintaining independence or slow disease progress
  •  Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:

  • Associates in Nursing or higher
  • Case Management Certification
  • Possess excellent verbal and written communication skills
  • Must be flexible, well organized, self-starter and team player

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life’s best work.(sm)

 Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.     

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.   

Job Keywords: RN Case Manager, DSNP, CSNP, SNP, Case Manager, Ontario, CA


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