Sr. RN Field Case Manager - Star Plus Waiver - Spring,TX - Full-time / Part-time

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 Senior 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'll perform home visits, 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. Want more flexibility, want more autonomy? Work from your own home and coordinate a visiting schedule that is mutually beneficial to you and the members we serve.
 
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.
 
Primary Responsibilities:

Visit Medicaid members in their homes and / or other settings, including community centers, hospitals or providers' offices
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
Completes all initial and annual service planning activities and verifies, authorizes, coordinates and monitors services
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 
Ensure LTSS and clinical programs are in place according to members wants and needs to include functional, medical, behavioral and social needs
Support members desires to live in the least restrictive setting as possible 
Assist members with the transition from a care facility back to their home

Required Qualifications:

Current, unrestricted RN license in the State
3+ years clinical experience in a hospital, acute care, home health/hospice, direct care or case management, able to quickly identify needs and issues
RUG certification or the ability to obtain within 30 days of employment
Medicaid, Medicare, Managed Care experience in long-term care, Long Term Services and Supports, home health, hospice, behavioral, public health or assisted living
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
Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs, Adult and/or Children with complex needs
Reliable transportation to travel to member homes or other locations within service delivery area
Preferred Qualifications:

Experience in case management and/or certification in case management (CCM)
Home care/field based clinical experience
Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
Experience in Home & Community based or Long Term Care Services delivery
Understanding of Waiver benefits and service plan
Bilingual skills
Careers at UnitedHealthcare Community & State. 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. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV / AIDS and high - risk pregnancy. Our holistic, outcomes - based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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 Manager, CCM, Home Care, Medicare, Medicaid, Spring, TX, Texas, Telecommute, Telecommuter, Telecommuting, Remote