Remote Complex Care Manager, RN (ID Focus)

Optum; United States; Remote; USD 40,000 - 72,000; Full time

Job summary

UnitedHealthcare is seeking a registered nurse to provide Complex Care Management for Idaho members remotely across the United States. You will engage in close phone-based communication, educate on conditions, perform medication reviews, and connect members to benefits and community resources.

You will collaborate with Care Coordinators to align outreach, care plans, and service coordination, while meeting Idaho-specific contractual requirements and supporting NCQA certification efforts.

Qualifications

• Current, unrestricted RN in the applicant's state of residence.
• 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.
• Intermediate level of proficiency with computer/typing to enter/retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications.
• Access to high-speed internet from home.
• Ability to support Idaho members while working remotely from anywhere within the U.S.; Idaho residency is not required.

Responsibilities

• Provide Complex Care Management for Idaho members through close communication by phone
• Support members with condition education, medication reviews and connections to covered benefits, community resources and long-term services and supports, when applicable
• Assist members with the transition from a care facility back to their home
• Support NCQA Care Management requirements through UHC's Care Management program, including assessment, care planning, member outreach, coordination, monitoring and documentation
• Collaborate with each member's assigned Care Coordinator to align outreach, care plan activities, service coordination, follow-up needs and escalation pathways
• Meet Idaho-specific contractual requirements related to the delivery of care management and member-centered coordination
• Support Idaho health plan in obtaining NCQA certification

Skills

RN license

Remote work

Computer skills

Internet access

Care coordination

Education

Bachelor's degree

Job description

UnitedHealthcare is seeking a registered nurse to provide Complex Care Management for Idaho members remotely across the United States. You will engage in close phone-based communication, educate on conditions, perform medication reviews, and connect members to benefits and community resources.

You will collaborate with Care Coordinators to align outreach, care plans, and service coordination, while meeting Idaho-specific contractual requirements and supporting NCQA certification efforts.