Registered Nurse Case Manager

Optum Home & Community Care, part of the UnitedHealth Group 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 At Home product, 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.

We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.

Field Case Manager RN in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home and virtual visits, consultations, and interdisciplinary team activities.

The Optum Dual Special Needs Plan (DSNP) at Home program is a longitudinal, integrated care delivery program that coordinates the delivery and provision of clinical care of members in their place of residence. The DSNP program combines Optum trained clinicians providing intensive interventions customized to the needs of everyone, in collaboration with the Interdisciplinary Care Team, which includes the Optum clinician, the member's Primary Care Provider and other providers, and other professionals.

The Field Case Manager RN supports the overall patient care management process for members in In-Home DSNP program. The Field Case Manager RN provides oversight, guidance and support for the patient care plan as developed in collaboration with the interdisciplinary care team along with the health plan and additional heath care vendors to meet the needs of the patient. The Field Case Manager RN coordinates and provides appropriate levels of care under the direct supervision of an RN / APC or MD. This position is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring, and evaluating). This includes case management, in home visit assessments, coordination of care, and medical management consulting. The Field Case Manager RN will also be responsible for home visits, transition of care management, providing health education, coaching and treatment decision support for members in At Home DSNP program.

Standard Hours : Monday - Friday 8AM - 6PM Central Time; (variable 8-hour shift), no nights, weekends, or holidays.

Location : North Kansas City, MO

Primary Responsibilities :

Assess the health status of members as within the scope of licensure and with the frequency established in the model of care

Establish goals to meet identified health care needs

Ensure members are obtaining preventative care to meet STARS\HEDIS measures

Plan, implement and evaluate responses to the plan of care

Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care

Works closely with mental health clinicians to help bridge the gap between mental and physical health

Consult with the patient's PCP, specialists, or other health care professionals as appropriate

Assess patient needs for community resources and make appropriate referrals for service

Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians

Completely and accurately document in patient's electronic medical record

Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit

Verify and document patient and / or family understanding of condition, plan of care and follow up recommendations

Actively participate in organizational quality initiatives

Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery

Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs

Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation, and relationships in the care provided to our members

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 :

Associates Degree (or higher) in Nursing OR equivalent Registered Nurse Diploma

Current unrestricted licensure as RN in state of Missouri

2+ years of experience as a Registered Nurse

6+ months of experience in assessing the medical needs of patients with complex behavioral, social and / or functional needs

Proven ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes)

Access to reliable transportation, as well as a valid driver's license that will enable you to travel up to 100 % of the time to visit clients

Preferred Qualifications :

1+ years of experience working with the geriatric population

Understanding of Medicare, Medicaid, and Health Plan benefit structures

Bilingual or Multilingual

Soft Skills :

Solid computer skills, including use of Electronic Medical Records

Effective time management and communication 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 $58,800 to $105,000 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.