Bilingual (English/Spanish) Case Manager RN - Remote in TX, AZ, CO, WY, and NM - Case Management

TieTalent; Fort Worth (TX); Remote; USD 58,000 - 115,000; Full time

Job summary

An established industry player is seeking a Bilingual Case Manager RN to enhance patient care through effective management of care transitions and coordination. This role involves collaborating with a dedicated care team to ensure high-risk patients receive the necessary follow-up and support. The position offers the flexibility of remote work while contributing to health equity and improving health outcomes. Join a diverse and inclusive culture that values your contributions and provides opportunities for professional growth. If you're passionate about making a difference in healthcare, this is the opportunity for you.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Equity stock purchase

Qualifications

• Bachelor's Degree required; RN licensure in applicable states.
• 4+ years in Case Management or Care Coordination experience.

Responsibilities

• Support patient engagement and care transitions management.
• Consult with patients post-discharge; facilitate follow-up appointments.
• Engage high-risk patients for medication reviews.

Skills

Bilingual (English/Spanish)

Case Management

Care Coordination

Communication Skills

Proficiency in Microsoft Office

Flexibility

Education

Bachelor's Degree

Tools

Microsoft Office

Outlook

Teams

Job description

Bilingual (English/Spanish) Case Manager RN - Remote in TX, AZ, CO, WY, and NM

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 to start Caring. Connecting. Growing together.

We are looking for a Case Manager RN as an addition to the team. The Case Manager drives Referral Management and appropriate sites of service, facilitates Care Transitions and Care for High-Risk patients; Collaborates with PCP, Specialists, and Clinical Pharmacist to ensure appropriate, coordinated service delivery. This position integrates pharmacy management, care coordination, utilization management, and care transition management.

Hours: Monday - Friday - 3 days from 8 AM - 5 PM in your time zone - 2 days - 10 AM - 7 PM in your time zone

If you reside in TX, AZ, CO, WY, or NM, you'll enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

1. Work with a Care Team of a Clinical Pharmacist and Clinical Administrative Coordinator to support patient and provider engagement for Care Transitions Management, Care Coordination, and Medication Therapy Management
2. Facilitate inpatient discharge information to Care Team and Primary Care Offices using appropriate technology tools
3. Consult with patients who have had an inpatient discharge; facilitate scheduling transitions of care follow up appointments with PCP and/or specialists
4. Consult with patients who have had an ED discharge; facilitate scheduling follow-up appointments as needed; review post-discharge information with patients and educate on alternative sites of care
5. Engage high-risk patients telephonically to schedule appointments with Clinical Pharmacist for Comprehensive Medication Reviews
6. Prepare patient cases in workflow management platform for Clinical Pharmacist patient engagement
7. Consult with patients identified as needing a specialist referral to recommend high quality, lower cost specialists
8. Support high-risk patients by scheduling PCP and/or specialist appointments on their behalf
9. Provide benefit information and resources to patients upon request
10. Communicate with provider offices to problem-solve patient issues and/or facilitate communication between practice staff and Care Team
11. Notify PCP and Care Team Clinical Pharmacist of relevant clinical information gathered during calls to patient that may affect the patient's disease state or medication regimen
12. Develop strong relationships with provider offices participating with Practice Extend program by communicating program goals, patient needs, and value-based opportunities
13. Facilitate and/or lead meetings with provider offices for initial onboarding meetings and ongoing collaboration meetings

Required Qualifications:

1. Bachelor's Degree (or higher)
2. Unrestricted, compact licensure as a Registered Nurse for applicable states within our program
3. 4+ years of Case Management and/or Care Coordination experience
4. 3+ years of experience in managing populations with complex medical or behavioral needs
5. Intermediate level of proficiency with Microsoft Office, Outlook, and Teams applications and ability to quickly learn clinical applications and multi system management
6. Intermediate level of ability to type and navigate a Window-based environment simultaneously
7. Bilingual in English and Spanish
8. Able to travel up to 10% to local office(s) to accommodate business needs
9. Ability to work a flexible schedule, including evenings up to 7pm, to accommodate business needs

Preferred Qualifications:

1. Prior experience in managed care and/or population health management
2. Case Management Certification (CCM)
3. Strong communication skills with patients, providers, and other healthcare professionals
4. Ability to provide proactive clinical feedback to enhance quality patient engagement and program growth
5. Able to take initiative and work independently
6. Adaptable, flexible, and able to incorporate frequent process changes into established workflows within a fast-paced, dynamic environment

All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Salary Information:

Colorado Residents Only: The salary range for Colorado residents is $58,300 to $114,300 per year. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

Application Deadline:

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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