Field Case Manager Nurse RN - Metro Atlanta Area - Telecommute - Full-time / Part-time

Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm)

*** This position will work primarily with a diabetic population and someone who is a Certified Diabetic Educator (CDE) or has worked primarily with diabetic patients is highly preferred ***

***This position has the potential to be a telecommute / work from home position once training period is completed***

This is a field based position traveling to provider offices in the Metro Atlanta, Georgia area as needed.  You will be responsible to review charts (paper and electronic - EMR), look for gaps in care, perform assessments, help coordinate doctor appointments, make follow-up calls to members after appointments, and assist our members in overall wellness and prevention.  This position is Monday - Friday during business hours.

As a Field-Based Case Manager, you'll wear many hats, and work in a variety of environments. Sometimes, you'll interact with members leaving the hospital - possibly with new medications or diagnoses. Or perhaps you will be assisting members with safe, effective transitions from care environments to where they live. You may also act as an intermediary between providers and members - serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more. The result? Fewer hospitalizations, ER visits and costly service gaps; and a less stressed, more effective health care system for us all. What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

Apply for this position with your eyes wide open. Click here to view the Realistic Job Preview: http: //uhg.hr/Field_Based_Case_Manager_UHCCS

Responsibilities:

• Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction


• Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels


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  Primarily provides care coordination/case management through physician practices for members to improve clinical quality and clinical documentation



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  Conducts face to face and telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols



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  Determines member's overall bio-psychosocial needs and develops individualized member service/care plan based on assessment data, member and caregiver/ stakeholder input, and cost-effective options for service delivery



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  Develops member goals in coordination with member and provider



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  Routinely and as needed evaluates the effectiveness of the care/service plan and makes appropriate revisions per policy and procedure / state contractual requriements



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  Facilitates appropriate member referrals to special programs such as Behavioral Health, Advanced Illness



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  Coordinates benefits through other available payment sources



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  Assists the member to access community, Medicare, family and other third-party resources as appropriate



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  Provides education to members regarding health care needs, available benefits and services

  
  

   

Required Qualifications:

Preferred Qualifications:

• Case Management experience


• Certified Diabetic Educator (CDE)


• Certification in Case Management


• Home care/field based case management


• Chart review experience to identify gaps in care


• Medicaid, Medicare, Managed Care experience


• Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs


• Bilingual skills


• Experience in Home & Community based or Long Term Care services delivery


• Bachelor's degree


• Experience working in a provider office

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, 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.

Key Words:  case manager, nurse, RN, registered nurse, GA, Georgia, Atlanta, MCO, managed care, chart review, wellness, provider, CDE, Certified Diabetic Educator