TRICARE RN Disease Case Manager - Phoenix, AZ - Full-time / Part-time

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. Talk about meaningful work. What an important role. Our UnitedHealthcare Military & Veterans organization has been selected to provide quality healthcare services for those who serve our nation. Make your last career change one of inspiration. Find out more about these opportunities to do your life's best work.(sm)   
 
We have an excellent opportunity available for you to bring your extensive experience and join our company as a Disease Management RN working in our Phoenix office. As a part of the DM team, you will be responsible for providing disease specific clinical case management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating.  
 
This position provides telephonic disease management and education in support of TRICARE beneficiaries identified primarily with Diabetes and also supporting other diseases, Asthma, COPD, and Heart Failure identified by the Department of Defense. 
***This is an office position located at 2222 W. Dunlap Ave. Phoenix, AZ ***
 
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:


Current, unrestricted RN license in the state of AZ  

2+ years of experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company  

Telephonic experience, i.e. phone triage, crisis line, disease management, case management  

Intermediate level of experience with Microsoft Word; Windows environment and toggling between multiple screen while typing and  talking on the phone

Intermediate level of knowledge doing Internet searches

United States Citizenship  

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


Bachelor's Degree  

A background in managed care  

Previous experience with Diabetes, COPD, Asthma, or Heart Failure  

Case Management experience  

Certified Case Manager (CCM)  

Experience / exposure with discharge planning  

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

Strong organizational skills and multitasking abilities
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: 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: Telephonic, CCM, Phoenix, Arizona, AZ, Nurse, clinical, RN, Registered Nurse, disease management, Diabetes, case management, COPD, Asthma, Heart Failure, CCM