UnitedHealth Group

Case Manager RN

UnitedHealth Group$60K — $107K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Associates degree required; BSN preferred
  • Active RN license in the state of employment
  • Minimum 3 years of experience in hospital or acute care settings
  • Proficient in typing and navigating a Windows-based environment
  • Certifications like ACM or CCM are advantageous
  • Experience in managed care and case management is a plus
  • Previous exposure to telephonic roles is desirable

Responsibilities

  • Educate Health System staff on changes in care management and utilization review
  • Assess patients' physical, psychosocial, and economic needs for transition planning
  • Document and validate data to monitor interventions and outcomes
  • Interview patients and collect data related to readmission risks
  • Communicate with outpatient providers to improve care continuity
  • Apply performance improvement and customer service principles in job responsibilities
  • Facilitate patient-centered care and collaborate with multidisciplinary teams for discharge planning

Benefits

  • Comprehensive benefits package including health and wellness programs
  • Incentive and recognition programs
  • Equity stock purchase options
  • 401(k) contribution plans
  • Robust professional development opportunities
Full Job Description
Responsibilities:

  • Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization review
  • Assessment of physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care; delegates to others as appropriate
  • Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomes
  • Interviews and collects patient specified data and chart review related to readmission and appropriately notifies care team
  • Communicates telephonically and electronically with outpatient providers in an effort to enhance the continuum of care
  • Integrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities; practice and governmental commercial payer guidelines
  • Adheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies
  • Assumes responsibility for NL EMMC required continued education and owns professional growth
  • Provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients / caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care
  • Drives to appropriate DRG length of stay, patient experience, and reimbursement for all patients
  • Promotes patient advocacy in an independent care model
  • Performs other duties as assigned or required


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:

  • Associates degree
  • Current, unrestricted RN license in the state of employment
  • 3+ years of experience in a hospital, acute care or direct care setting
  • Must be able to type and have the ability to navigate a Windows based environment


Preferred Qualifications:

  • BSN
  • Background in managed care
  • Case management experience
  • ACM, CCM or other certification applicable to utilization management
  • Experience or exposure to discharge planning
  • Experience in utilization review, concurrent review or risk management
  • Previous experience in a telephonic role
  • Answer the call to use your diverse knowledge and experience to make health care work better for our patients. Join us and start doing your life's best work


Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

About UnitedHealth Group

UnitedHealth Group is a medical facility. They offer health technology, health finance, and pharmacy services. They are utilizing clinical data and intelligence to assist in the redesign, automation, and deployment of technology to streamline administrative operations and clinical decision-making. Payment systems for both consumers and providers are critical components of a health-care system.

UnitedHealth Group Careers

Joining UnitedHealth Group means becoming part of a diverse team dedicated to making a difference. As a leader in health services and innovation, our company offers a variety of job opportunities that allow professionals to leverage their skills, drive innovation, and improve lives. Work You’ll Do At UnitedHealth Group, you’ll contribute to a mission-focused environment where your expertise will influence the health and well-being of people worldwide. Our employment opportunities span across a wide range of disciplines, from healthcare specialists to data analysts, ensuring that your career journey is both dynamic and rewarding. Transform Healthcare with Your Expertise UnitedHealth Group stands at the forefront of health innovation. Our team collaborates to deliver solutions that lead to better patient outcomes. Working with us, you’ll find yourself at the intersection of technology, healthcare, and leadership, providing key insights that drive industry transformation. Join Our Global Team As part of our team, you’ll engage with over 300,000 professionals globally, dedicated to building a diverse and inclusive workplace. UnitedHealth Group is not just a company; it’s a community where you can grow your career through continuous learning and leadership opportunities. Our commitment to diversity training ensures that every team member can thrive. UnitedHealth Group Career Development We are committed to your professional growth. Explore career paths filled with promising job opportunities and internships that will harness your potential and expand your capabilities. Whether you’re a seasoned professional or a recent graduate, you’ll find that our career development programs support your ambition at every level. Innovative Work Environment At UnitedHealth Group, innovation is at the core of our operations. We encourage our team to bring forward-thinking ideas that challenge the status quo and lead to breakthrough improvements in patient care. Be Part of a Great Team Our culture fosters a collaborative and supportive environment where every member’s contribution is valued. Enjoy the benefits of being part of a global team that’s committed to making a difference in people’s lives. Future-Proof Your Career With UnitedHealth Group, your career is future-proof. Dive into a range of positions that offer both challenges and rewards. Our robust support system includes unmatched training, development programs, and certification support to propel your career forward. Stay Connected Join Our Team Discover the right position that matches your skills and interests. We are always hiring and look for passionate, curious, and solution-driven team players. Search UnitedHealth Group jobs today and take the first step towards a fulfilling career. Keep Up to Date Stay informed with career tips, insider perspectives, and industry-leading insights you can use today—all from the people who work here. Read Careers Blog Job Alert Emails Customize your subscription to receive job alerts, the latest news, and insider tips tailored to your preferences. Explore the exciting and rewarding opportunities that await at UnitedHealth Group.
Learn more about UnitedHealth Group
Size
350,000 employees
Market Cap
$493.1 billion
Industry
Net Income
$15.4 billion
Founded
1974
5 Year Trend
+9.2%
Revenue
$257.1 billion
NASDAQ

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