Telephonic Nurse Case Manager - office based - Full-time / Part-time

• The NCM is first and foremost an advocate for the patient in all activities including nursing assessments, care coordination, care plan development, and communication.


• This position is accountable for identifying and developing innovative actions to meet the needs of INSPIRIS patients from both the health care and psychosocial / socioeconomic dimensions of care as well as taking action for provision of services to meet those needs.


• The NCM utilizes nursing assessment skills and decision making authority to make recommendation and direct patient care to meet the needs of the patient and support the care recommendations of the HBP.


• The NCM, as part of the patient care team, works closely with the HBP to coordinate all needed care and service; as well as ensuring services are completed timely and effectively through oversight of the order process


• The NCM participates in the development of the patient risk management plan and ensures that the identified actions are completed per the plan


• The NCM actively participates in case management conferences


• The NCM will represent INSPIRIS through facilitation of the communication process with external customers such as community physicians, contracted vendors, health plan clients, families, patients, caregivers, the community and the media.


• The NCM will provide support and assistance for patients and families through the development of a bonding telephonic relationship.

• An unrestricted and active RN license in state of residence


• 3+ years of clinical experience post licensure


• 1+ year of Nurse Case Manager experience with INSPIRIS or 2+ years Case Management experience


• Basic knowledge of Microsoft Word, email, Internet and cell phones


• Familiarity with ICD-9 and CPT-4 coding


• Must be able to effectively communicate with elderly and chronically ill patients and families using the telephone

• Case Management certification is a plus


• Understanding of Medicare, Medicaid and Health Plan benefit structures


• Experience in Managed care


• Experience in utilization management, risk management and/or quality management


• Bi-lingual or multi-lingual

UnitedHealth Group is working to create the health care system of tomorrow.



Already Fortune 14, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.



Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.



Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: RN, nurse, case management, CCM, certified case manager, chronic illness Medicare, Medicaid, risk management, utilization management, managed care, ICD-9, CPT4