Telephonic RN Case Manager in West Chester, Ohio

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)

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

SHIFT ***Monday-Friday, 11am to 8pm (with an hour break) or 11:30am to 8pm (with a 30 min break)***

***This shift also includes the potential for occasional weekend hours***

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Position Summary:

As a 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.  This may include case management, disease management, coordination of care and medical management consulting.  You will also be responsible for providing health education, coaching and treatment decision support for members.

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:

• Current, unrestricted RN license in the State of Ohio


• 3 years of experience in a hospital setting, acute care, direct care experience


• Computer proficiency including the ability to type and talk at the same time and to navigate a Windows environment


• Must be able to work the designated shift


• Must be within a commutable distance of the West Chester office (45 minutes or less)


• Strong organizational skills and multitasking abilities


• Strong communication skills, both written and verbal

Additional Assets Preferred:

• BSN


• Experience as a telephonic Case Manager for another insurance company


• A background in managed care


• Certified Case Manager (CCM)


• Experience/exposure with discharge planning


• Experience in utilization review, concurrent review and/or risk management

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 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: 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.

Job keywords: RN, registered nurse, case manager, case management, telephonic case manager, West Chester, OH