Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm)

As a Telephonic Case Manager you will primarily be responsible for implementing day-to-day Telephonic Case Management interventions for identified high risk members. drive positive outcomes by supporting a diverse member population with education, advocacy and the connections to the resources they need.

What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

This position is a work from home / telecommute opportunity. Candidates must be located within a commutable distance (50 minutes or 50 miles) of our New York, NY office (77 Water Street).

Primary Responsibilities:

* 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 track findings

* Utilize Milliman criteria to determine if patients are in the correct hospital setting

* Make "welcome home" calls to ensure that discharged member receive the necessary services and resources


To be considered for this position, applicants need to meet the qualifications listed in this posting.

Required Qualifications:

* Current, unrestricted RN license in the state of New York

* Valid New York state ID for system access

* 2+ years clinical experience (any setting)

* Must be willing / able to obtain CCM within 2 years of employment

* Proficient level of experience with MS Office applications (Word, Excel, Outlook and PowerPoint)

Preferred Qualifications:

* Bachelor's Degree of higher in Nursing

* Managed Care experience

* Case Management experience highly preferred

* Certified Case Manager (CCM)

* Disease Management experience

* Home Health experience

* Knowledge of Medicare guidelines and regulations

* Bilingual skills (Russian or Spanish)

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.


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.

Job Keywords:
RN, Registered Nurse, Nurse, Licensed, Care Coordinator, Case Manager, Case Management, Medicare, Medicaid, Medicaid Waiver, MDS, Managed Care, Home Health, Behavioral Health, Mental Health, Community Health, Long Term Care, LTC, Hospice, Public Health, Assisted Living, UAS, UAS Assessor, Telecommuter, Telecommute, Telecommuting, Remote, NY, New York, New York City, UHG, UnitedHealth Group, UHC, UnitedHealthcare, Community and State, Public Sector

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