RN Telephonic Case Manager, Heart Failure - Greensboro, NC

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
 
This position is primarily responsible for implementing day-to-day case management interventions for identified high risk members. 
 
Primary Responsibilities:

Making outbound calls to assess members' current health status
Identifying gaps or barriers in treatment plans
Providing patient education to assist with self-management
Interacting with Medical Directors on challenging cases
Coordinating care for members
Making referrals to outside sources
Coordinating services as needed (home health, DME, etc.)
Educating members on disease processes
Encouraging members to make healthy lifestyle changes
Documenting and tracking findings
Utilizing Milliman criteria to determine if patients are in the correct hospital setting
Making “welcome home” calls to ensure that discharged member receive the necessary services and resources 

Required Qualifications:


Active, unrestricted RN license in the state of North Carolina
3+ years clinical experience (any setting)
Intermediate / proficient level of experience with MS Office applications
Passion and commitment to excellence
Positive attitude and solution-oriented
Ability to handle multiple tasks and function in a high volume environment
Ability to work well as part of an interdisciplinary team
Must be willing / able to obtain CCM within 2 years of employment
Must live within a commutable distance of our Greensboro, NC office location
Preferred Qualifications:

BSN
Experience in managed care, case management and / or disease management 
Certified Case Manager (CCM)
Knowledge of disease processes for chronic illnesses in the senior population
Home Health experience
Knowledge of Medicare guidelines and regulations
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: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and 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:  RN, nurse, case manager, care manager, home health, geriatric, telephonic, Medicare, Greensboro, NC, North Carolina