Telephonic RN Case Manager - Remote from a Compact State

$58,300 - $114,300/Yr

Optum - Dallas, TX

Full-time - Mid Level

Remote - Dallas, TX

Insurance Carriers and Related Activities

About the position

As an RN Telephonic Nurse Case Manager at Optum, you will play a crucial role in clinical operations and medical management activities across the continuum of care. This position involves assessing, planning, implementing, coordinating, monitoring, and evaluating care for members. You will provide health education, coaching, and treatment decision support, all while working remotely from anywhere in the U.S. The role requires flexibility, including working until approximately 8pm on two days a week based on member availability.

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 and services as needed (home health, DME, etc.)
• Educating members on disease processes
• Encouraging members to make healthy lifestyle changes
• Utilizing Milliman criteria to determine if patients are in the correct hospital setting
• Making 'welcome home' calls to ensure that discharged members receive the necessary services and resources
• Documenting and tracking findings

Requirements

• Active, unrestricted RN license in a compact state
• 3+ years of clinical experience (any setting)
• Computer proficiency utilizing MS Office (Word, Excel, PowerPoint and Outlook)
• Ability to type and talk at the same time while navigating a Windows environment
• Reside in a location that can receive a UnitedHealth Group approved high speed internet connection
• Access to dedicated workspace from home for in-home office setup

Nice-to-haves

• BSN
• Certified Case Manager (CCM)
• ICU, Cardiology or Critical Care experience
• Telephonic case management experience
• Experience with discharge planning
• Experience in a remote position
• Bilingual - English/Spanish
• Solid working knowledge of chronic medical diagnoses (CHF, COPD, diabetes, etc.)

Benefits

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