Telephonic RN Case Manager - HIV/AIDS - Telecommute - 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 Telephonic RN Case Manager - HIV/AIDS - Telecommute, 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: 

• Develop and maintain excellent performance and quality service for the Care Management team


• Maintain a focus on the customer service through policy and program decisions and consider impact of these activities on the members


• Facilitate interdepartmental communication as needed for integration purposes


• Facilitate problem resolution with members, providers, and other agencies or entities as needed


• Conduct initial and follow-up assessments within designated timeframes on patients identified as having highest risk complex case management needs (assessment areas include clinical, behavioral, social, environmental and financial)


• Assess the patient's current medical and social circumstances to identify any gaps or barriers that would impact compliance with the prescribed treatment plan


• Engage patient, family, caregivers, and healthcare providers to assure that a well-coordinated treatment plan is established


• Utilize holistic approaches to patient care and integrates patient's life and motivational goals into the treatment plan


• Prioritize care needs, set goals and develop a treatment plan (or plan of care) that also addresses gaps and/or barriers to care and uses evidence-based practice as the foundation


• Track the patient's health status and progress in achieving clinical and personal goals


• Provide education, information, direction, and support related to care goals of patients


• Coordinate acquisition and proper use of medical equipment, initially and on an ongoing basis


• Communicate with patients, families, caregivers, physicians, and other service providers to coordinate the care needs for the patient


• Work to facilitate patient compliance and to ensure continuity of care


• Monitor and evaluate the patient's response to treatment(s)


• Collaborate with the attending physicians and Medical Director to revise treatment plans as needed


• Document assessments, interventions, and follow-up on disease management activities


• Regularly assess the effectiveness and quality of services provided to patients by analyzing outcomes (clinical, functional, and financial)


• Maintain a focus on timely, quality customer service


• Maintain the confidentiality of sensitive information


• Complete all Ethics and Integrity education programs


• Use company resources appropriately (e.g., technology, supplies)

Required Qualifications:

• Clinical Registered Nurse with current licensure in state of New Jersey


• Bachelor's degree in Science or equivalent work experience


• Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint


• Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance and achieve targets


• Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action


• Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others

Preferred Qualifications:

• Master's degree


• Experience working in Medicaid and/or Medicare health care and insurance industry, including regulatory and compliance requirements


• 3+ years Clinical background, experience in behavioral health and complex community case management


• A minimum of 1 year complex case management experience


• Bilingual

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: 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: Registered Nurse, RN, case manager, case management, managed care, HIV, AIDS, field-based, telecommute, work from home