Senior RN Case Manager - Las Vegas, NV

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 Senior RN Case Manager manages case management services and directs care coordination for high risk members and post acute care discharges. May be clinic based or virtual office. Option for clinic, home, and telephonic visits. The Sr. RN Case Manager works in collaboration with members, providers and key stakeholders in coordinating health services and referrals. Collaborates with physicians and assists in the facilitation of healthcare resources to ensure services and care are delivered in a timely manner. Advocates for patients/families and liaisons with key team member to ensure that patients' healthcare needs are being addressed.

This role is with United Healthcare's Health Plan of Nevada Care For Me Program

The Senior RN Case Manager will be on-site at Health Plan of Nevada's network partner clinics that are located all throughout the Las Vegas/Henderson area

Primary Responsibilities:

• Applies motivational interviewing in identifying impact on member engagement and setting goals


• Medication: Member education, medication reconciliation and benefit management


• Ensures follow up appointments and referrals to programs, both health plan and community are in place


• Facilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as needed


• Communicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient care. Identified point of contact for managing transitions of care


• Utilizes approved clinical criteria to asses and determine appropriate level of care for members currently receiving inpatient care


• Reevaluates transition of care needs at day 30 and coordinates transition to next level of case management or care coordination services

Required Qualifications:

• Minimum five years clinical experience in a hospital setting with an emphasis on case management or utilization management


• Registered Nurse with active unrestricted license in the State of Nevada


• High School diploma or higher


• Certification in Case Management (completed or obtained within one year of employment in position)


• Strong understanding of insurance products, benefits, coverage limitations, laws and regulations as it applies to the health plan


• Thorough knowledge of UM, case management and discharge planning


• Strong organizational skills


• Strong interpersonal, verbal and written communication skills


• Critical thinking skills and ability to oversee teams to meet expected goals


• Self-motivated for member and program success


• Ability to contribute to the organization's efforts to eliminate racial and ethnic disparities in organizational performance

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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: Senior RN Case Manager, case management, RN, registered nurse, senior case manager, Las Vegas, NV, Nevada, United Health Group