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Job Details

UnitedHealth Group

Registered Nurse Case Manager - Tucson, AZ


Nurse Manager


Tucson, Arizona, United States

**$2,500 Sign-On Bonus for External Candidates **

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

An RN functions as part of the primary care team, and reports to the Clinical Services Manager (CSM). The RN performs activities that fall within the RN scope of practice. This role works in close collaboration with all of the team members, and may support multiple providers. The RN works under the direction of the provider, and activities are delegated to the RN by the provider or the team CSM. The RN understands and supports the CPM models of care Institutional Special Needs Plan (ISNP), Institutional Special Needs Plan (IESNP) and Transitions to Skilled (TTS), and works in collaboration with the team to meet the goals of the program. RN may be required to provide on-site clinical support to patients or facilities.

Primary Responsibilities:

  • Care Coordination
    • Assist the provider/team with various care coordination activities in the nursing home and/or assisted living community (AL)
    • RN works in collaboration with the nursing facilities/AL community to assist in coordinating transportation when appropriate
  • Benefit Determination
    • Assist the provider/team with benefit determination associated with Medicare part A, part B, and part D benefits
    • The RN is responsible for collaborating with the nursing facility/AL to identify and respond to patient Change in Condition
    • RN may assist the provider by completing DSTs, re-assessing the patient, and other activities to support BD, as delegated by the provider or the CSM
  • Therapy Coordination
    • Assist the provider/team with therapy coordination for patients including possible assessments or follow up on requests and communicate/collaborate with NP
    • The RN may perform interval check in on patient progress with therapy department
    • The RN may participate in facility based therapy discussion meetings
  • Team Support
    • Schedule and participate in family conferences, team meetings, and team case presentations
    • Assist in the coordination of N95 fit testing, CPR training/recertification, tracking compliance with infection control measures, tracking TAP data etc.
    • Participate in the onboarding of new clinical staff under the direction of the CSM- the RN may coordinate onboarding activities, and participate in other orientation activities under the direction of the CSMs or DCOs
    • Participate in facility partnership or Customer Relationship Management (CRM) meetings under the direction of the NP/CSM- the RN may assist in coordinating CRM meetings, and may participate in and contribute to the meetings
    • The RN may assist the team in tracking LearnSource completion for the team members and CSM
  • In-servicing
    • Assist in creating and conduct in-services for selected audiences
  • Documentation
    • Will document information and activities in the EMR
    • RN may assist Providers in assuring complete and accurate coding
  • Advanced Care Planning
    • Assist the team/providers in prioritizing advance Care Planning and initiating discussions
  • Communication
    • Collaborates with all key stakeholders; providers, nursing homes/assisted living facilities, PCPs, families, interdisciplinary care teams and any other identified stakeholders
  • Support of contracted providers
    • May support contracted providers with above activities and other selected duties in appropriate markets Quality/HEDIS
  • Quality/HEDIS
    • The RN will review the chart and enter HEDIS/Quality information into the EMR
    • The RN may identify gaps in the HEDIS/Quality measures and communicate these to the NP for resolution. i.e. missing vaccinations, lab work etc.
    • The RN may assist with managing the annual flu vaccine initiative; communicate with families, nursing staff, identify gaps
    • The RN may do the Medication Reconciliation post hospital, skilled event or ER visit
  • Patient Care
    • Patient assessment for Change in Condition - RN may perform a nursing assessment on a patient within scope of practice, communicate findings back to NP
    • The RN may make rounds and identify high risk patients
    • RN may be required to provide on-site support to patients or facilities
    • The RN may gather information for rounds and enter into preliminary note as described in the documentation section
    • The RN may write verbal orders from Provider in the chart in compliance with the state RN practice laws, and in compliance with individual nursing facility practices

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:

  • Current unrestricted Registered Nurse license in the state of practice
  • 3+ years of RN experience
  • Valid driver's license with appropriate insurance
  • 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

Preferred Qualifcations:

  • Baccalaureate degree
  • Experience with using an Electronic Medical Record
  • Experience working in post- acute care, such as long term care or hospice and/or Case Management experience as an RN
  • Experience working with the geriatric population
  • Basic Microsoft Office skills with the ability to navigate in a Window's environment
  • Familiarity with the long term care business environment
  • Excellent communication and customer service skills

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.