At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The Complex Case Manager, RN is responsible for establishing a person-centered, culturally relevant goal-oriented care plan. Care coordination includes case management, disease management, discharge planning, transition planning, and addressing social determinants of health.
This position is a Field-Based position with a Home-Based office. Expected travelling 3-5 days per week within 30-60-mile radius. The counties covered by this position are
If you reside locally to or within 30 miles of Douglas County, KS and surrounding
counties, KS or surrounding areas, you will enjoy the flexibility to telecommute* as you take on some tough challenges.Primary Responsibilities:
- Assess, plan and implement care strategies that are individualized and directed toward the most appropriate level of care for Medicare and Medicaid members while proactively engaging the member to manage their own health and healthcare
- Utilize strong skill sets of managing multiple tasks at a time, being self-motivated, driven toward quality results, managing time well, being very detailed oriented and organized, work well in a team and on your own, and ability to manage multiple deadlines
- This is high volume, high pace, customer service environment. Must be efficient, productive and thorough dealing with our members over the phone and in person
- Must be strongly patient-focused and adaptable to changes
- Proactively engage the member to manage their own health and healthcare using Motivational Interviewing Skills
- Highly detailed charting on member's reported needs, medical and behavioral health history, current management of their health concerns and social determinacies of health needs and medication reconciliation
- Manage the Transitions of Care for members when discharged from in-patient hospital stays and emergency room
- Help member set goals and develop a care plan to achieve those goals and update their care plan regularly as they progress toward goals met
- Support the member to improve their wellbeing by staying out of the hospital, and attend regular visits to their primary physician and specialists
- Identify and initiate referrals for social service programs; including financial, community resources, medical, behavioral health, psychosocial, community and state supportive services
- Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
- Advocate for Persons as needed to ensure the Person has access to care
- Provide clinical support for nonclinical staff of the team, in way of education on medications, diagnosis and disease specific education
- Collaborate with interdisciplinary team to ensure appropriate services and identify needs
- Strong computer and software navigation skills are critical
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:
Current, unrestricted independent licensure as a Registered Nurse in Kansas
2+ years of experience working within the community health setting in a healthcare role
1+ years of experience working with people with long-term care needs
1+ years of experience working with people receiving services on one of the homes and community-based waivers in KS
1+ years of experience working with MS Word, Excel and Outlook
Ability to travel in assigned regions to visit Medicaid members in their homes and / or other settings, including community centers, hospitals, or providers' offices
Must reside in or within 30 miles of one of the following (Douglas County, KS and surrounding counties)
Access to reliable transportation & valid US driver's license
Preferred Qualifications:
Background in managing populations with complex medical or behavioral needs
Experience with electronic charting
Experience with arranging community resources
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
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 hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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