Optum

Telephonic RN Case Manager - Remote from a Compact State - Case Management

Posted on

March 24, 2025

Job Type

Full-Time

Role Type

Case Management

License

RN

State License

Compact / Multi-State

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Company Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Job Description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. As an RN Telephonic Nurse Case Manager, you will be responsible for clinical operations and medical management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating. You will also be responsible for providing health education, coaching and treatment decision support for members. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. The schedule for this position includes 2 days per week where you will be expected to work until approximately 8pm, based on member availability.

Requirements

Required Qualifications: Active, unrestricted RN license in a compact state 3+ years of clinical experience (any setting) Computer proficiency utilizing MS Office (Word, Excel, PowerPoint and Outlook), including the ability to type and talk at the same time while navigating a Windows environment Reside in a location that can receive a UnitedHealth Group approved high speed internet connection or can leverage existing high - speed internet service Access to dedicated work space from home for in home office set up Preferred Qualifications: BSN Certified Case Manager (CCM) ICU, Cardiology or Critical Care experience Telephonic case management experience Experience with discharge planning Experience in a remote position Bilingual - English/Spanish Solid working knowledge chronic medical diagnoses (CHF, COPD, diabetes, etc.) All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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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 and services as needed (home health, DME, etc.) Educating members on disease processes Encouraging members to make healthy lifestyle changes 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 Documenting and tracking findings

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