Telephonic Case Manager RN- Richardson, TX - Future Telecommuting Potential!

There is a work-at-home potential with this position!  Work-at-home will be assessed post-training and the chosen incumbent must demonstrate independence and excellence in their position before telecommuting is considered an option.
 
What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in 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.
 
*** Shift will be consumer hours 10:00am - 7:00pm or 11:00am - 8:00pm CST ***
 
We offer competitive benefits, including tuition assistance and financial support towards obtaining industry - specific certifications and licensures.
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
3+ years experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
Basic level of experience with Microsoft Word, Outlook, Excel, and Internet
Preferred Qualifications:


Bachelor's Degree
A background in managed care
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 will be keys to success
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, Case Management, Utilization review, Richardson, TX, Texas