What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere Hours will be consumer shift: 11:00am-8:00pm Position could eventually allow for some work at home light privileges. That would consist of working from a home setting 2 days a week and in the office the remaining 3 days a week.We offer competitive benefits, including tuition assistance and financial support towards obtaining industry - specific certifications and licensures.Primary Responsibilities: Making outbound calls to assess members' current health status Identifying gaps or barriers in treatment plans Providing patient education to assist with self management Interacting with Medical Directors on challenging cases Coordinating care for members Making referrals to outside sources Coordinating services as needed (home health, DME, etc) Educating members on disease processes Encouraging members to make healthy lifestyle changes Documenting and tracking findings Utilizing Milliman criteria to determine if patients are in the correct hospital setting Making 'welcome home' calls to ensure that discharged member receive the necessary services and resources
Required Qualifications: Current, unrestricted RN license in the State 3+ years RN experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company Basic level of experience with Microsoft Word, with the ability to navigate a Windows environmentPreferred Qualifications: Bachelor's Degree A background in managed care Case Management experience Certified Case Manager (CCM) Experience / exposure with discharge planning Experience in utilization review, concurrent review and / or risk management, strong organizational skills and multitasking abilities will be keys to successCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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 Management, Utilization review, Richardson, TX, Texas
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.