Sr RN Case Manager SNF

$70,200 - $137,800/Yr

UnitedHealth Group - Las Vegas, NV

Full-time - Mid Level

Las Vegas, NV

Insurance Carriers and Related Activities

About the position

The Senior Case Manager will play a crucial role in identifying, coordinating, and providing appropriate levels of care under the supervision of an RN or MD. This position is responsible for clinical operations and medical management activities across the continuum of care, including case management, coordination of care, and medical management consulting. The role also involves providing health education, coaching, and treatment decision support for members, ensuring a comprehensive approach to patient care.

Responsibilities

• Applies motivational interviewing in identifying impact on member engagement and setting goals.
• Member education, medication reconciliation, and benefit management.
• Ensures follow through with the Care Navigation Team; timely appointments and referrals to programs, health plan, and community.
• Facilitate patient/family and provider communications as indicated and advocate for patient/family with healthcare team as needed.
• Ensures coordinated services delivered and available programs are accessed.
• Communicate with stakeholders, appropriate health care related information to ensure timely coordination care and services for members currently receiving inpatient care.
• Utilizes approved clinical criteria to assess and determine appropriate level of care for members currently receiving inpatient care.
• Identified point of contact for managing transitions of care.

Requirements

• Current, unrestricted NV RN license
• 3+ years of direct patient care nursing with a focus on discharge planning or case management
• Knowledge of UM and plan benefit designs
• Knowledge of Utilization review and MCG
• Competent with MS Office and other practice management systems or possess the ability to continue to learn new things
• Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area

Nice-to-haves

• CCM certification
• Solid clinical knowledge and capacity for continued learning
• Proficient in critical thinking skills of RN Case manager
• Proven ability to organize and prioritize tasks for self and patients
• Proven solid verbal and written communication skills
• Demonstrated ability to perform case management activities

Benefits

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