Complex Case Manager

UnitedHealth Group; Idaho; Remoto; USD 40.000 - 72.000; Tempo pieno

Descrizione del lavoro

UnitedHealth Group is seeking a Complex Case Manager to provide comprehensive care management for Idaho members. The role emphasizes communication, education, and support, with the flexibility of remote work and a full-time day shift.

Responsibilities include condition education, medication reviews, and coordinating with community resources, while ensuring NCQA compliance and seamless transitions from facilities to home.

Competenze

• Current, unrestricted RN license in the state of residence.
• 2+ years of clinical experience in hospital, acute care, home health, hospice, direct care, or case management.
• 1+ year of experience working with individuals with special healthcare needs.

Mansioni

• Provide Complex Care Management for Idaho members via close phone communication.
• Educate on conditions, review medications, and connect to benefits and community resources.
• Assist transitions from care facilities back to home.
• Support NCQA Care Management requirements through assessment, planning, outreach, coordination, monitoring and documentation.
• Collaborate with the assigned Care Coordinator to align outreach and care plans.
• Meet Idaho-specific contractual requirements for care management and coordination.
• Support Idaho health plan in obtaining NCQA certification.

Conoscenze

Communication skills

Care coordination

Remote work adaptability

Formazione

RN license in applicant state

Descrizione del lavoro

About This Role

The Complex Case Manager at UnitedHealth Group will provide comprehensive care management for Idaho members, focusing on communication, education, and support for individuals with complex healthcare needs. This role is ideal for those looking to make a significant impact on patient care while enjoying the flexibility of remote work.

Highlights

• Pay: $29 - $52/hour
• Location: Boise, ID
• Schedule: Full Time, Day shift

What You'll Do

• Provide Complex Care Management for Idaho members through close communication by phone.
• Support members with condition education, medication reviews, and connections to covered benefits and community resources.
• Assist members with the transition from a care facility back to their home.
• Support NCQA Care Management requirements through assessment, care planning, member outreach, coordination, monitoring, and documentation.
• Collaborate with each member's assigned Care Coordinator to align outreach and care plan activities.
• Meet Idaho-specific contractual requirements related to care management and member-centered coordination.
• Support Idaho health plan in obtaining NCQA certification.

Requirements

• Education:
  • Current, unrestricted RN in the applicant's state of residence
• Experience:
  • 2+ years clinical experience in a hospital, acute care, home health/hospice, direct care, or case management
  • 1+ years of experience directly working with individuals with special healthcare needs
• Licenses & Certifications:
  • Current RN License in the applicant's state of residence

About UnitedHealth Group

UnitedHealth Group is a leading healthcare provider committed to delivering exceptional patient care. They focus on simplifying the healthcare experience and improving health outcomes for individuals across the country.