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Hours Full-time, Part-time
Location Phoenix, AZ
Phoenix, Arizona

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)


 

Want to learn more before applying for this role? Click here to view the Realistic Job Preview:

 

If you want more meaning in your career - as a clinician or a business professional - think of OptumHealth as your calling...

 

As a Case Manager, RN for the Kidney Resource Services program, 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.

 

***The schedule for this position includes some evening work where you will be expected to work until approximately 8pm, based on member availability. For example 11am to 8pm OR a split shift 8am to 2pm and then from 5 to 8pm***

 

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 and services as needed (home health, DME, etc)


  • Making referrals to outside sources


  • 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

Requirements


The chosen candidate must possess:


  • Current, unrestricted RN license in your State of Residence  

  • 2+ years of experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company

  • 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

  • Strong written and verbal communication skills

  • Attention to detail, organizational skills and multitasking abilities will be keys to success 

Candidates who also have one or more of the following will be preferred:


  • Diabetic educator experience

  • Renal or Dialysis Care experience

  • Chronic Kidney disease experience

  • Certified Case Manager (CCM)

  • Experience with discharge planning

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

  • Telephonic case management experience

  • A Background in managed care

  • RN license in a compact RN license state

  • BSN

 


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.