TRICARE Renal RN Case Manager - Multiple Locations!

Talk about meaningful work.  Talk about an important role.  Let's talk about your next career move.  Our UnitedHealthcare Military & Veterans organization has been selected to provide quality health care services for those who serve our nation.  This is an opportunity to share in something special; an opportunity for all of us to serve those families who have made our nation stronger. It's an inspiring role and it can inspire your career.  Find out more about these opportunities to do your life's best work.(SM)

UnitedHealthcare Military and Veterans have an excellent opportunity available to join our company as a Case Manager for the Chronic Kidney Disease Program. Positions in this function include RN (with current licensure) roles that identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. This position would be responsible for clinical operations and medical management activities across and continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating).  This includes case management coordination of care, and medical management consulting. This position is responsible for providing health education, coaching and treatment decision support for beneficiaries.

Kidney Program!

This is a office position located at either of our offices in Colorado Springs, Colorado, Phoenix, AZ, or Honolulu, HI

Office hours for this position are 7:00am-3:30pm

Responsibilities:

• Document all clinical information in accordance with UnitedHealthcare Military & Veterans policies and procedures


• Assess and interprets beneficiary needs, gaps, and requirements


• Leads efforts to provide specialized case management services to beneficiaries identified with very complex conditions or diseases requiring intensive and extensive coordination of resources including accessing Centers of Excellence with specialty hospitals, multiple specialists and sub-specialists, DME, home care and therapy providers


• Solves moderately complex problems and/ or conducts moderately complex analyses


• Develops plan of care in collaboration with beneficiary/caregiver/provider


• Works with minimal guidance, seeks guidance on only the most complex tasks


• Translates concepts into practice


• Provides explanations and information to others on difficult issues


• Collaborates with specialists, physicians, and medical directors to provide the necessary care and cost efficient care for the beneficiary


• Assesses the effectiveness and quality of services provided related to clinical, functional, and financial impact and outcomes


• Coordinating services as needed


• Maximizes use of community services, support programs, and resources available to beneficiary


• Educating beneficiary on disease processes


• Assist with projects and/or assignments designated by the Team Lead, Supervisor or Manager


• Adhere to the timeframes surrounding contractual terms as related to obtaining clinical information, communication with providers and internal disciplines


• Refer all cases that fall outside of standard criteria to the medical Director for review, per UnitedHealthcare Military & Veterans policy and procedure


• Adheres to ethical, legal/regulatory and accreditation standards

Required Qualifications:

• 2-5 years of experience in a clinical setting in a renal care environment


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  Unrestricted, RN license in the state of Colorado


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  Bachelor's degree preferred - Undergraduate degree or equivalent experience, including specialty experience where required


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  Clinical competence in understanding hospital care and care coordination


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  Ability to develop and sustain trusting and respectful relationships with beneficiaries, families, advocates, medical partners and others


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  Detail oriented and organized


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  Flexible schedule


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  Approved Case Management certification is preferred, or obtainment of certification within 18 months of hire on assuming the position


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  Familiar with Microsoft Word & Excel and has computer/technical aptitude


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  United States Citizenship 


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  Ability to obtain favorable adjudication following submission of Department of Defense eQuip Form SF86

Preferred Qualifications:

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  Experience working with the military is desired


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  Case management experience desired


• Business background and/or experience preferred


• CNN-Certificate Nephrology Nurse is desired

As a requirement of UnitedHealth Group's contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense , (the National Agency Check Legal and Credit or NACLC).  Successful completion of the NACLC process is a requirement for continued employment in this role.  NACLC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense.  Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received.  Failure to obtain final NACLC approval will result in termination from this role.   

Careers at UnitedHealthcare Military & Veterans. When it comes to their health care, the men and women who help keep the peace deserve the greatest peace of mind. That's why UnitedHealthcare is the organization that's called on to serve them and their loved ones. We're all about finding better ways to help improve their lives no matter where life may take them. So our career opportunities take challenge to a higher level. If you have a commitment to quality that mirrors our commitment to the men and women of the armed forces, take time to learn more about the career paths available here. It's a genuine 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.

Job Keywords: CM, Case Management, Kidney, Nurse, RN, Renal,Chronic Kidney Disease, Dialysis, Colorado, Colorado Springs, CO, HI, AZ, Phoenix, Honolulu, military, TRICARE, Hawaii, Arizona