Hybrid RN Utilization Case Manager - Home Visits

Palo Verde Community College District; Milwaukee (WI); Hybrid; USD 60,000 - 107,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

401k contribution

Equity stock purchase (eligible)

Job summary

UnitedHealth Group, the parent company of UnitedHealthcare, seeks a Utilization Case Manager to serve Milwaukee County with occasional coverage in surrounding counties. The role offers a mix of office and home-based work with field visits about 25% of the week.

As part of care coordination, you will conduct outbound calls, perform home assessments, educate members, coordinate services, and work with Medical Directors to optimize care plans while following state guidelines and quality standards.

Qualifications

• Current, unrestricted RN license in the State of Wisconsin.
• 2+ years of experience in a hospital setting, acute care, direct care experience or Home Health Case Manager experience.
• Basic level of experience with Microsoft Office and EMR applications.
• Reliable transportation to travel to member homes within the 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

RN license

2+ years hospital care

EMR familiarity

Microsoft Office

Reliable transportation

Travel up to 25%

Education

RN license Wisconsin

Tools

EMR systems

Microsoft Office

Job description

UnitedHealth Group, the parent company of UnitedHealthcare, seeks a Utilization Case Manager to serve Milwaukee County with occasional coverage in surrounding counties. The role offers a mix of office and home-based work with field visits about 25% of the week.

As part of care coordination, you will conduct outbound calls, perform home assessments, educate members, coordinate services, and work with Medical Directors to optimize care plans while following state guidelines and quality standards.