Manager of Case Management - Field RN in East TX

• Support clinical operations across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating)


• Engage in case management and coordination of care, supporting Service Coordinator team members in the field


• Takes lead role in setting direction and participating in or developing new programs


• Sets team direction, resolves problems and provides guidance to members of the team


• Ensures team meets established performance metrics and performance guarantees


• Adapts departmental plans and priorities to address business and operational challenges


• Plans, organizes, and oversees staff to ensure timely completion of assessments


• Oversees the department's daily staffing requirements to meet program standards


• Implements and interprets organizational policies and procedures, reviews work of staff to ensure that policies and guidelines are appropriately applied


• Other duties as assigned to support team

• BSN


• A background in managed care


• Medicare and/or Medicaid experience


• Case Management experience


• Certified Case Manager (CCM)


• Experience/exposure with discharge planning


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

Careers at UnitedHealthcare Community & State. 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. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)