Case Manager, RN - Troy, MI - 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 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.

Apply for this position with your eyes wide open.  Click here to view the Realistic Job Preview:

Primary responsibilities include managing all transitions between health care settings and facilitating the appropriate level of care based on the severity of illness and intensity of service. Transitions management includes medication reconciliation and patient education on red flag warning signs through patient activation techniques.

Primary Responsibilities:

• Assess and interprets customer needs, gaps, and requirements


• Performs transitions coaching using the Coleman model


• Facilitates patient activation using PAM research and tools


• Solves complex problems and/ or conducts moderately complex analyses


• Develops care plan in collaboration with consumer/caregiver/provider


• Works with minimal guidance, seeks guidance on only the most complex tasks


• Translates concepts into practice


• Provides explanations and information to others on difficult issues


• Coaches, provides feedback, and guides others


• Collaborates with specialists, physicians, and medical directors to provide the medically necessary and appropriate care for the customer


• Assesses the effectiveness and quality of services provided related to clinical, functional, and financial impact and outcomes


• Improving unhealthy lifestyles and sustaining healthy behaviors for our consumers


• Maximizes use of community services, support programs, and resources available to customer


• Educates and supports consumer's treatment to assist them in the best decision making for their health and wellness


• Takes in-bound calls and places out-bound calls as dictated by consumer and business needs


• Act as a resource for others with less experience


• Department specifics may vary including onsite case management working within the skilled nursing facility for ongoing clinical support during SNF care as well as post discharge collaborating with social workers, patients, families and post-acute bundled payment team


• Works with SNF staff collaboratively to improve clinical outcomes during the SNF stay thru effective transitions to the home setting reducing readmission rates


• Adheres to ethical, legal/regulatory and accreditation standards


• Other duties as assigned

Required Qualifications:

• Current, unrestricted RN in the state of MI


• Undergraduate degree or equivalent experience         


• 3 + years of experience  as an RN with clinical competence in understanding skilled nursing facilities, rehab, assisted living and/or home health care coordination


• Astute triage skills


• Self-directed worker


• Proficient level of experience with Microsoft Word, with the ability to navigate a Windows environment


• Able to travel to facilities within region for onsite case management


• Ability to visit patients in their homes

Preferred Qualifications:

• BSN


• Transitional coaching experience high preferred


• Home care experience highly desirable


• Case Management experience


• Certified Case Manager (CCM)


• Knowledge of Medicaid, Medicare, and government/CMS regulations


• Bilingual

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:  RN, registered nurse, skilled nursing, long term care, assisted living, home health, case manager, case management, transitional care, Troy, MI, Michigan