Hybrid RN Utilization Case Manager & Care Coordinator

UnitedHealthcare; Milwaukee (WI); Hybrid; USD 60,000 - 107,000; Full time

Benefits offered by this job

Benefits package

Incentive programs

Equity stock purchase

401k contribution

Job summary

UnitedHealthcare is seeking a Utilization Case Manager to serve Milwaukee County with travel up to 25% to surrounding areas. The role supports a hybrid office/remote setup, requiring residency within commutable distance of Milwaukee, WI.

Responsibilities include assessing health status, home visits, coordinating care, and educating members on disease management, with collaboration from Medical Directors to optimize care plans.

Qualifications

• Current, unrestricted RN license in the State of Wisconsin
• 2+ years of experience in a hospital setting, acute care, direct care experience or experience as a Home Health Case Manager
• Basic level of experience with Microsoft Office and other electronic medical record applications
• Reliable transportation to travel to member’s homes within the geographical area
• Willing to travel up to 25% to member homes

Responsibilities

• Making outbound calls to assess members' current health status
• Conducting face to face assessments in the member’s home
• Assisting members in identifying unmet needs
• Documenting assessment details and applying State guidelines to requests for services
• Documenting and tracking findings
• 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

Skills

Microsoft Office

Travel readiness

Education

Registered Nurse (RN) license in Wisconsin

Tools

Electronic Medical Record (EMR) systems

Job description

UnitedHealthcare is seeking a Utilization Case Manager to serve Milwaukee County with travel up to 25% to surrounding areas. The role supports a hybrid office/remote setup, requiring residency within commutable distance of Milwaukee, WI.

Responsibilities include assessing health status, home visits, coordinating care, and educating members on disease management, with collaboration from Medical Directors to optimize care plans.