Case Manager RN
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.SM
We are looking for a Care Coordinator as an addition to the UHC Spectrum Team. Spectrum Care Coordinator is responsible for ongoing Clinical Care Coordination and Care Management for patients attributed to Physician/Physician Practices participating in UnitedHealthcare’s UHC Spectrum Program. The Care Coordinator drives Referral Management and appropriate sites of service, facilitates Care Transitions and Care for High-Risk patients; Collaborates with PCP, Specialists, and Spectrum Clinical Pharmacist to ensure appropriate, coordinated service delivery. This position integrates pharmacy management, care coordination, utilization management, and care transition management.
Schedule: Monday - Friday 8:00 AM - 5:00 PM
Location: Fully remote in the Baltimore, MD area as position requires 10% travel to providers offices
If you reside in Baltimore, Maryland, you will enjoy the flexibility to telecommute* as you take on some tough challenges.
- Consult with patients identified by PCP as needing a Specialist Referral to recommend High Quality, Lower Cost Premium Designated Specialists; facilitates appointments with Specialists
- Facilitate discharge information provided to Care Team and Primary Care Offices using appropriate Technology tools
- Consult with patients who have had an Inpatient/ER Discharge; facilitates scheduling transitions of care follow up appointments with PCP/Specialists
- Track completion of Referral, Care Transition, and PCP appointments with ongoing communication to patients while discussing adherence with Care Plan
- Check-in on the patient as needed to evaluate and document his/her progress as it relates to care coordination and management responsibilities tied to the Spectrum Program to collaborate with Care Team and PCP regarding patient needs and potential barriers to adherence
- Educate patients about their condition, medication, benefit plan, and care path
- Motify PCP and Pharmacist on the Care Team of relevant clinical information gathered during calls to patient that may affect the patient's disease state or medication regimen
- Develop strong relationships with Physician offices participating with Spectrum program by communicating program goals, patient needs, and value-based opportunities
- Facilitate and/or lead meetings with Physician offices for initial onboarding meetings and ongoing collaboration meetings
- Communicate with Physician office to problem-solve patient issues and/or help facilitate communication between practice staff and Care Team
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.
- Bachelor’s degree (or higher) OR 4+ years of experience as an RN or Social Case worker
- Unrestricted licensure as a Registered Nurse or Licensed Social Worker (LCSW) in the state of Maryland
- 4+ years Case Management and/or Care Coordination experience
- Intermediate level of proficiency with Microsoft office - Outlook, Excel, and Word
- Ability to travel up to 10% to local office(s) to accommodate business needs
- 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
- Experience working remotely (or from home) in a care coordination type of role
- Clinical or Behavioral Health degree
- Background in managing populations with complex medical or behavioral need
- Background in healthcare setting with an understanding of chronic conditions and best practices
- Strong communication skills with patients, providers, and other healthcare professionals
- Ability to quickly learn Clinical Applications
- Strong emotional intelligence with ability to remain focused and calm when navigating many tasks in a fast-paced environment
- Ability to work flexible schedule to accommodate business needs
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. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.