Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Field Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!Location: Field based position throughout Marietta, GA area.Work Schedule: Monday through Friday 8am-5pm, hours may differ pending business/member needs.Primary Responsibilities:
Perform initial review of consumer health records and current health status (e.g., health risk scores) to identify health risk and determine next steps
Conduct initial and ongoing assessments utilizing nursing assessment skills in home setting
Receive information from consumers about specific symptoms and questions
Conduct interviews to understand cause and effect, gather or review health history for clinical symptoms, and determine health literacy
Evaluate consumer data throughout the assessment process to identify inconsistencies and adherence to Evidence Based Guidelines from both the health care and psychosocial / socioeconomic dimensions of care
Identify and prioritize gaps to develop plan of care and short and long-term goals to empower consumers to meet identified goals
Determine consumer's willingness to engage in plan of care and readiness for change
Identify appropriate interventions and resources to meet gaps (e.g., psychosocial, transportation, long-term care) based on specific consumer needs from both the health care and psychosocial / socioeconomic dimensions of care
Document the plan of care in appropriate EHR systems and enter data per specified format
Maintain consumer engagement by establishing rapport, demonstrating empathy, and building a trusting relationship
Collaborate with primary providers or multidisciplinary team to align or integrate goals to plan of care and drive consistent coordination of care
Provide ongoing support for advanced care planning
Reassess plan of care at appropriate intervals based on initial objectives, significant change of condition, or achievement of goals
Understand and operate effectively / efficiently within legal/regulatory requirements
Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results
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:
Associate’s degree or higher in nursing
Active, un-encumbered RN license to practice nursing in the state of Georgia
1+ years of experience working with complex patient populations including multiple chronic diseases with diverse psychosocial backgrounds
1+ years of experience in a hospital, acute care or direct care setting
Demonstrated ability to type and have the ability to navigate a Windows based environment
Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
Preferred Qualifications:
BSN
Certified Case Manager (CCM)
1+ years of experience working in home health or in-home setting
Understanding of Medicare, Medicaid, and Health Plan benefit structures
Basic knowledge of computers and cell phones
Proven excellent organizational skills with the ability to multi-task and manage
Proven comfortable working independently in a home-visit setting
Proven effectively communicate with elderly and chronically ill patients and families
Proven excellent collaboration skills and ability to communicate with care team and physicians
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.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employers 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.