Senior Case Manager RN - AL

Requisition Number: 2358183
$2,500 Sign On Bonus for External Candidates
Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum Care at Home team, together with an interdisciplinary care team we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. This life-changing work adds a layer of support to improve access to care. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.
As a Senior Case Manager in our Atlanta office, you will assist with escalated cases and internal / external vendor interface, participate in customer calls and meetings as required; coach staff on team, complete quality case and call audits; conduct phone calls to consumers if needed to achieve the team outreach goals or coverage for case managers.
Must be interested in career path as a Clinical Manager. Position will also review patient status over the phone while ensuring they are receiving the best care.
Primary Responsibilities:

• Serve as a mentor and coach to staff case managers
• Handle escalated cases from team
• Interact directly with vendors and account management
• Make outbound calls to assess members' current health status
• Identify gaps or barriers in treatment plans
• Provide patient education to assist with self-management
• Interact with Medical Directors on challenging cases
• Coordinate care for members
• Make referrals to outside sources
• Coordinate services as needed (home health, DME, etc.)
• Educate members on disease processes
• Encourage members to make healthy lifestyle changes
• Document and tracking findings
• Make post-discharge calls to ensure that discharged member receive the necessary services and resources

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:

• Current, unrestricted RN license in the State of Alabama
• Willingness and ability to obtain additional licensures as needed
• Ability to obtain CCM within 24 months of assuming role
• 3+ years of RN experience in a hospital setting, acute care, direct care experience
• 1+ years of leadership background experience
• 1+ years of experience as a Case Manager in a managed care setting
• Computer proficiency, to include solid data entry skills and the ability to navigate a Windows environment
• Driver's License and access to reliable transportation

Preferred Qualifications:

• BSN or Master's degree
• Background in managed care
• Disease management experience
• Experience / exposure with discharge planning
• Medical / Surgical, Home Health, Diabetes or Cardiac experience (certification in one of those specialties)
• Bilingual (Spanish / English) skills

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.