RN Case Manager - Dayton, OH

Talk about meaningful work.  Talk about an important role.  Let's talk about your next career move. UnitedHealth Group is offering an innovative new standard for health advocacy.   We are seeking Registered Nurses who share our passion for helping people live healthier lives to join our team.  It's an inspiring role and it can inspire your career.  For those who want to invent the future of health care, here's your opportunity.  Find out more about these opportunities to do your life's best work.(SM)

Counties:  Montgomery, Greene, Clark

Work Monday - Friday Telecommute with 75% Local Travel

This position works in tandem with the Optum Nurse Practitioner/Physician Assistant to establish and maintain effective relationships with Optum members, key decision-makers, facility staff, and collaborating physicians.  The RN coordinates information and services between Optum NP/PA, program enrollees and their families, Physicians, and facility staff and delivers exceptional health care within the RN scope of practice and Optum's Care Model.
 
Responsibilities:

• Understands the Optum benefits and associated policies and procedures, and articulates them effectively to providers, members, and key decision-makers.


• Provides new and existing member support including RAF/coding and documentation of key measures into EMR to positively impact market. 


• In coordination with the NP/PA, the RN will discuss use of inappropriate, high cost, poor outcome services, such as hospitalizations, by utilizing other resources or benefits.


• Gathers information from the on-call team to appropriately triage and collaborate with the NP/PA to provide timely and appropriate care in the facility.


• Independently provides hands on physical assessments and collaborates with the NP/PA to provide comprehensive and individualized plans of care based on each member's goals of care. 


• Provides effective family communication and education and attends care conferences.


• Responsible for the coordination of benefits including applying for and managing skilled time, DME, ancillary services, etc. 


• Coordinate readmission efforts including initial and follow up assessments, providing necessary monitoring of skilled benefits, and reconciling medications.


• Risk stratify members and collaborates with the NP/PA to prioritize visits. 


• Help extend the reach of the NP/PA and support staff during staffing challenges.


• Responsible for organizing and tracking all appropriate therapies.


• Maintains a cooperative relationship among interdisciplinary teams by communicating information, responding to requests, building rapport, participating in team problem-solving methods, and may be required to attend key facility meetings.
   

Requirements:

• Active and unrestricted RN license in the State of Ohio


• 3-5 years of experience in Long Term Care and/or Case Management


• Excellent communication and relationship building skills


• Experience with Medicare / Medicaid


• Strong computer and assessment skills - proficiency with Microsoft Word


• 75% local travel required.  Must have reliable transportation, valid driver's license, and proof of car insurance.

Physical Requirements:

Must have the ability to:

• Lift up to 40 pounds.


• Carry the case up and down stairs and pull up a ramp.


• Freely carry a laptop and/or book and paper in arms/hands.


• Push and/or pull up to 30 - 40 pounds including up and down ramps.


• Type on a key board and to touch a screen with a wand.


• Bend, squat up and down motion several times a day.


• Sit and stand throughout the day.  Amount of time varies based on RN
  caseload and practice.


• Transporting equipment, supplies and paper information (books, documents) requires packing the carrying case or bag, pulling the case if on wheels, carrying the case by the handle or shoulder strap.

Assets:

• Baccalaureate Degree


• HEDIS / HOS experience


• CCM Certified Case Manager 

UnitedHealth Group is working to create the health care system of tomorrow.

We are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Job keywords:  RN, Registered Nurse, Long Term Care, Case Management, HEDIS, Telecommute, Work-from-home, Dayton, Montgomery, Greene, Clark, Ohio, OH