Post-Acute Inpatient RN Case Manager - Telecommute in Las Vegas, NV
Location: Las Vegas, Nevada
Internal Number: 109947825
UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)
Are you ready for your next challenge? Discover it here at UnitedHealth Group and help us reinvent the health system. We're going beyond basic care, providing integrated health programs with a member-centric focus. The challenge is ensuring we deliver the right care at the right time. When you join us as an Post-Acute Inpatient RN Case Manager, you'll be making a difference in peoples' lives and will be responsible for discharge planning, improved transitions of care, and utilization management of hospitalized health plan members. You will ensure patients receive quality medical care in the most appropriate setting.
Performs the following case management skills on a daily basis:
Perform patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial)
Develop individualized discharge plans that involve provider, patient, and caregiver goals for successful transitions of care
Implement discharge plan involving health care resources across the continuum
Monitor and report variances that may challenge timely quality care
If you are located within Las Vegas, NV you will have the flexibility to telecommute* as you take on some tough challenges.
Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care
Utilize both company and community based resources to establish a safe and effective case management plan for hospitalized members
Collaborate with patient, family, and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge plan
Communicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized members
Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team
Utilize approved clinical criteria to assess and determine appropriate level of care for hospitalized members
Understand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health plan
Accountable to understand role and how it affects utilization management benchmarks and quality outcomes
Provides health education and coaches consumers 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 heath care cost
Coordinates services and referrals to health programs
Prepares individuals for physician visits
Assesses and triages immediate health concerns
Manages utilization through education
Identifies problems or gaps in care offering opportunity for intervention
Assists members in sorting through their benefits and making choices
Takes in-bound calls and places out-bound calls as dictated by consumer and business needs
Special projects, initiatives, and other job duties as assigned
Work completed in Sub - Acute facilities or Acute Hospital settings
Occasional driving up to one (1) hour daily for regular employees per diem employees will drive less than one hour daily and are not subject to the driving requirements
**Candidates must be willing to travel locally up to 25% of the time to various LTACHs, skilled nursing and acute rehab facilities within the Las Vegas and Henderson area. **
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.
Registered Nurse with active, unrestricted license in the State of Nevada
3+ years of adult clinical experience in a hospital setting
Intermediate level of proficiency using a PC in a Windows environment, including MS Word and Excel
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
CCM certification or ability to obtain within 2 years of employment
Case management/utilization review experience
Experience in a managed care organization
Acute hospital experience in one or more of the following areas: LTACH, med-surg, ER, psychiatric, ICU or IMC
Rehab facility experience in one or more of the following areas: skilled nursing or acute inpatient rehab
Knowledge of Interqual or MCG
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)
Nevada Residents Only: The hourly range for Nevada residents is $28.85 to $51.30. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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.