Manage complex care cases for members through outbound health assessments, treatment-gap identification, education, referrals, discharge follow-up, and coordination of services such as home health and durable medical equipment. Collaborate with Medical Directors, apply Milliman criteria to evaluate hospital appropriateness, document findings, and support members’ self-management and healthy lifestyle changes. The role requires onsite work in Cheektowaga, New York for the first 6–12 months, with possible hybrid arrangements later.
Requisition Number: 2394771
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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephonic Nurse Case Manager, you'll support a diverse member population with education, advocacy, and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!
The schedule is Monday - Friday: 3 days/week 8 am - 5 pm, 2 days/week 11 am - 8 pm. Working until 8pm two nights/week is required.
Selected candidates must be able to start working on site in our office located at 600 Airborne Pkwy, Cheektowaga, NY. Opportunities for hybrid arrangements may be given over time based on business needs and if all job goals are being met.
Primary Responsibilities:
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:
Preferred Qualifications:
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephonic Nurse Case Manager, you'll support a diverse member population with education, advocacy, and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!
The schedule is Monday - Friday: 3 days/week 8 am - 5 pm, 2 days/week 11 am - 8 pm. Working until 8pm two nights/week is required.
Selected candidates must be able to start working on site in our office located at 600 Airborne Pkwy, Cheektowaga, NY. Opportunities for hybrid arrangements may be given over time based on business needs and if all job goals are being met.
Primary Responsibilities:
- Make outbound calls to assess members' current health status
- Identify gaps or barriers in treatment plans
- Provide patient education to assist with self-management
- Interact with Medical Directors on challenging cases
- Coordinate care for members
- Make referrals to outside sources
- Coordinate services as needed (i.e., home health, DME, etc.)
- Educate members on disease processes
- Encourage members to make healthy lifestyle changes
- Document and track findings
- Utilize Milliman criteria to determine if patients are in the correct hospital setting
- Make 'welcome home' calls to ensure that discharged members receive the necessary services and resources
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:
- Active, unrestricted RN license in the State of New York
- Multiple state licensure (in addition to Compact License if applicable) OR the ability to obtain multiple state nursing licenses
- 3+ years of RN experience in a hospital setting, acute care, direct care, or as a Case Manager at an insurance company
- Computer proficiency including navigating a Windows environment; using MS Outlook; creating, editing, saving, and sending documents in MS Word; talking and typing at the same time; and using multiple applications simultaneously
- Willing or ability to work Monday - Friday: 3 days/week 8 am - 5 pm and 2 days/week 11 am - 8 pm
- Willing or ability to work onsite in our Cheektowaga, NY office for the first 6-12 months
- Access to install secure, high-speed internet and a dedicated workspace at home
- Resides in New York
Preferred Qualifications:
- Bachelor's degree
- Certified Case Manager (CCM)
- Home health experience
- Managed care experience
- Case management experience
- Maternal experience
- Experience with/exposure to discharge planning
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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