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Case Manager RN

Optum Westborough, Massachusetts
manager rn health rn manager team management nursing patients medical insurance caregiver patient care
January 25, 2023
Optum
Westborough, Massachusetts

$2,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS

Combine two of the fastest-growing fields on the planet with culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that s improving the lives of millions. Here, innovation isn t about another gadget, it s about making health care data available wherever and whenever people need it, safely and reliable. There s no room for error. Join us and start doing your life s best work. (sm)

At United Health Group (UHG), our interdisciplinary teams collaboratively manage our complex patient panels. These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care provided by Case Manager RN, Social Workers, Pharmacists, Behavioral Health and other employed team members.

The Case Manager RN, is an integral part of the Interdisciplinary care team (IDT), and is responsible for the overall care management process for high acuity engaged UHG patients. The Case Manager RN has oversight for developing patients plan of care, providing education, guidance and support. Professionals in this role elicit input from the IDT based on initial comprehensive and ongoing assessments of the patient.

The Case Manager RN uses nursing assessment and evaluation skills to help guide treatment and care decisions of the team and identifies services and vendors for needed care while navigating patient benefit plans. The Case Manager RN works collaboratively with a multidisciplinary team to provide supportive care to enrolled patients. The IDT multidisciplinary team consists of the PCP, specialists, behavioral health clinicians, mid-level practitioners, pharmacist, nutritionist and social worker and the patient, family and/or caregiver.

The Case Manager RN ensures that medical services are managed in the most effective and appropriate health care setting according to the patient s medical condition. The plan of care addresses the clinical condition and psycho/social needs to maximize his/her level of functioning and establishes and maintains communications with all parties.

Scheduled Weekends: Part-time 20 hours on the weekend , can be either two 10 hour shifts or two 8-hour shifts with 4 hours during the week. No nights or Holidays

You ll enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Acts as an advocate for the patient in all activities including nursing assessments, care coordination, care plan development, and communication
  • Completes an initial and ongoing patient assessment, including a medical record review where available
  • Documents current advance care directive status and ongoing efforts to reconcile patient/caregiver goals with the current clinical status
  • Initiates and maintains ongoing communications with clinicians and primary care physician
  • Engages with families/responsible parties to collaborate on plan of care and discussion of the ongoing management of the patient s condition
  • Coordinates care needs are met across the continuum of care delivery model, as the point of contact for patient/caregiver and clinicians
  • Acts as liaison between providers, nursing facilities, hospitals and program staff, including making recommendations about care alternatives or equipment that will aide in the safety of the patient while promoting optimal clinical outcomes
  • Monitors patient progress against plan of care goals with an emphasis on patient care needs during transitions and health changes
  • Monitors patient during admissions and provides nursing/assisted living facility and provider training on program philosophy and approach to patient care
  • Educates patients and/or families/responsible parties on disease processes and ways to manage disease progression as independently as possible
  • Identifies and reports any quality-of-care issues and maintains HIPAA compliance as it relates to patient care

What are the reasons to consider working for UnitedHealth Group? Put it all together competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
  • More information can be downloaded at: http://uhg.hr/uhgbenefits

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 degree or higher in Nursing (RN)
  • 1+ years of experience with using an Electronic Medical Record
  • Unrestricted RN license for the state of Massachusetts
  • Ability to obtain the Unrestricted RN license for the state of Rhode Island, Connecticut and New Hampshire with in a 12 month period of employment
  • Case management experience
  • 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. May need to enter work facility for staff meetings.

Preferred Qualifications

  • BSN is preferred
  • 1+ years of clinical practice in a hospital, clinic, home care, or nursing home setting
  • Access to high speed internet
  • Disease management and/or physician office experience
  • Effective Communication skills and time management
  • 1+ years of experience working with the geriatric population

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 with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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.

**PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus

Job Keywords: Remote in Massachusetts, RN, Registered Nurse, UHG, health care, CCM, Case Manager, #RPO, #Green, hiring immediately, work at home, WAH, Massachusetts


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