For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm) This position is primarily responsible for implementing day-to-day case management interventions for identified high risk members. Primary 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 Documenting and tracking findings Utilizing Milliman criteria to determine if patients are in the correct hospital setting Making "welcome home" calls to ensure that discharged member receive the necessary services and resources
Required Qualifications:Active, unrestricted RN license in the state of Florida 3+ years clinical experience (any setting) Intermediate / proficient level of experience with MS Office applications: Word, Outlook, and Excel Must be willing / able to obtain CCM within 2 years of employment (fees paid for by UHG) Must live within a commutable distance of our Miami, FLMust be bilingual in Spanish (read, write and speak)Preferred Qualifications:BSN Experience in case management, disease management or other managed care setting Certified Case Manager (CCM) Knowledge of disease processes for chronic illnesses in the senior population Home Health experience Knowledge of Medicare guidelines and regulationsCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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. Job Keywords: RN, nurse, case manager, care manager, home health, geriatric, elderly, high risk, telephonic, Medicare, Miami, FL, Florida
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.