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Field RN Case Manager - Chapel Hill NC - Full-time / Part-time
| Hours | Full-time, Part-time |
|---|---|
| Location | Chapel Hill, NC Chapel Hill, North Carolina |
About this job
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)
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.
This is a field based position traveling to provider offices in the Chapel Hill, NC area. 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. You will be working at the provider office on a daily basis. This position is Monday - Friday during business hours.
Apply for this position with your eyes wide open. Click here to view the Realistic Job Preview:
Primary 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
Primarily provides care coordination/case management through physician practices for members to improve clinical quality and clinical documentation
Conducts face to face and telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols
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
Develops member goals in coordination with member and provider
Routinely and as needed evaluates the effectiveness of the care/service plan and makes appropriate revisions per policy and procedure / state contractual requirements
Facilitates appropriate member referrals to special programs such as Behavioral Health, Advanced Illness
Coordinates benefits through other available payment sources
Assists the member to access community, Medicare, family and other third-party resources as appropriate
Provides education to members regarding health care needs, available benefits and services
Requirements
Required Qualifications:
- Current, unrestricted RN license in the State of North Carolina
- Reliable transportation to travel to provider offices within service delivery area
- 3+ years clinical experience in a hospital, acute care, home health/hospice, direct care or case management
- Computer/typing proficiency to enter/retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications
- Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
- Ability to communicate complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
- Must live within a commutable distance (45 - 60 minutes) of Chapel Hill, NC
Preferred Qualifications:
- Case Management experience
- 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
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, Chapel Hill, NC, North Carolina, MCO, managed care, chart review, wellness, provider, Stars Rating System, Medicare, CCM