RN, Telephonic Case Manager - Remote

About the position

As a Telephonic Case and Disease Manager RN at Optum, you will play a crucial role in supporting a diverse member population by providing education, advocacy, and connections to necessary resources. This high-volume role requires critical thinking and a customer service approach, allowing you to impact millions of lives positively. You will work remotely, making outbound calls to assess health statuses, coordinate care, and encourage healthy lifestyle changes, all while ensuring thorough documentation and effective communication with medical professionals.

Responsibilities

• Making outbound calls to assess members' current health status
• Identifying gaps or barriers in treatment plans
• Providing patient education to assist with self-management
• Interacting with Medical Directors on challenging cases
• Coordinating care for members
• Making referrals to outside sources
• Coordinating services as needed (home health, DME, etc.)
• Educating members on disease processes
• Encouraging members to make healthy lifestyle changes
• Accurately and timely documentation of member progress
• Making 'welcome home' calls to ensure that discharged members receive the necessary services and resources

Requirements

• Active and unrestricted RN License in your state of residence
• Willingness and ability to obtain additional RN licenses as necessary
• 3+ years of RN experience in a hospital setting, acute care, direct care, or as a telephonic Case Manager for an insurance company
• Computer proficiency including navigating a Windows environment; using MS Outlook; creating, editing, saving, and sending documents in MS Word; talking and typing at the same time; and using multiple applications simultaneously
• Access to install secure, high-speed internet and a dedicated, distraction-free workspace at home

Nice-to-haves

• Bachelor's degree
• Active and unrestricted RN license in Minnesota
• Certified Case Manager (CCM)
• Managed Care experience
• Case Management experience
• Call Center experience
• Experience with / exposure to discharge planning
• Experience with utilization review, concurrent review and / or risk management

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution