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High Risk Case Manager RN - New York City Area
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | New York, NY New York, New York |
About this job
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. Join us and help people live healthier lives while doing your life's best work.(sm)
The High Risk Case Manager will manage the care of high risk members primarily telephonically, with the possibility of some in person assessments in their homes, facilities, doctors office or other community settings by completing health assessments, post hospital assessments, and coordinating patient care. The RN Case Manager will provide clinical and medical management services, including case management, care coordination, health assessments, interventions, and discharge planning. Work is generally fast paced, self-directed and not prescribed; this person will work from home when not completing face-to-face patient assessments.
***This is a telecommute / potential field opportunity and must be a resident of New York. The territory for this position can include Suffolk, Kings and/or Bronx***
Responsibilities for Case Managers include:
- 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
***If you do not have a current CCM, you will need to obtain one within 30 months of start date***
Requirements
- Current residence in the State of New York
- Current, unrestricted RN license in the State of New York
- 1+ year of clinical experience
- Case Management experience
- Level of proficiency with Microsoft Office, with the ability to navigate a Windows environment and ability to type and talk at the same time
- Strong organizational skills and multitasking abilities
- Reliable transportation with appropriate insurance, and the willingness to travel in local area as needed
Additional Preferred Assets:
- Bachelor's Degree in Nursing, Masters preferred
- Certified Case Manager (CCM)
- 1+ years of Home Health or other Field based experience
- Prior experience working in a health plan or other managed care setting
- Previous experience with the Medicaid population
Careers 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 largest 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: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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