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in Irvine, CA

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Hours Full-time, Part-time
Location Irvine, CA
Irvine, California

About this job

What's the first thing that happens when one of the most successful physician groups in Orange County comes together with a global leader in health care? Opportunity. With Monarch HealthCare joining Optum and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success.


 


For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)


 


As a part of our continued growth, we are searching for a Nurse Case Manager to join our team. This is a full time Nurse Case Manager position based on-site at our Irvine, CA office. New Grad Registered Nurses will be considered.


 


Primary Responsibilities:



  • Taking in-bound calls and placing out-bound calls as dictated by consumer and business needs

  • Providing Case Management services to dual eligible members

  • Provides health education and coaches members on treatment alternatives to assist them in best decision making

  • Supports consumers in selection of best physician and facility to maximize access, quality, and to manage healthcare costs

  • Coordinates services and referrals to various healthcare programs

  • Assesses and triages immediate health concerns

  • Identifies problems or gaps in care offering opportunity for intervention

  • Assists members in sorting through their benefits and making choices

Requirements

Required Qualifications:



  • Current, unrestricted RN license in the State of California

  • Excellent written and verbal communication skills

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

  • Ability to work under pressure and prioritize responsibilities

  • Must have an understanding of change and the ability to move members through the continuum of change

Preferred Qualifications:



  • RN experience

  • Experience working with dual eligible (Medi-Medi) population

  • Case Management experience

  • Certified Case Manager (CCM)

  • Utilization Management experience

  • Managed Care experience

  • Bilingual - Spanish , Vietnamese, Korean or Farsi

  • BSN

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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
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Job Keywords: Case Manager, CM, UM, Utilization Management, RN, Registered Nurse, Medicaid, Medicare, Medi-Cal, Irvine, CA, California