Remote Medical-Behavioral RN Case Manager

Jobtome; Lynnwood (PA); Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group is seeking an experienced MB I NCM (Nurse Case Manager) to serve as a clinical liaison between the care delivery network and members, coordinating plans and services to meet health needs. The role includes evaluation visits across settings, care planning, and CMS-compliant documentation.

The position offers field visits, telework options, and a comprehensive benefits package. Willingness to travel locally up to 75% is required; valid driver’s license and transportation are

Qualifications

• Active and unrestricted licenses.
• RN with 2+ years of experience.
• Proficient computer skills and good working knowledge of Microsoft Word.
• Proven ability to maintain direct and open communication with all levels of the organization.
• Proven ability to handle sensitive issues with members and providers in a confidential manner according to HIPAA guidelines.
• Demonstrates initiative in achieving individual, team, and organizational goals and objectives.
• Demonstrated ability and flexibility to assume responsibilities and tasks in a constantly changing work environment.
• Ability to travel locally up to 75% of the time for patient home visits.
• Driver's License and access to reliable transportation.

Responsibilities

• Screens and identifies members with high-risk, long term chronic conditions who will benefit from care management services.
• Performs member evaluations and onsite visits as needed in multiple settings, including telephonic, member's homes, PCP/Specialists clinic, hospital, and skilled nursing facilities and provides feedback on planned interventions and outcomes of the plan of care.
• Performs comprehensive assessments, identifies and assists members with high-risk symptoms/diagnoses and/or members with multiple co-morbidities who will benefit from intervention and engaging in care management services.
• Documents findings and develops individualized careplans in a concise/comprehensive manner compliant with CMS regulations.
• Utilizes advanced clinical skills to make effective decisions to meet the member's health, behavioral health and psychosocial needs.
• Documents patient/family status, diagnosis, medications, treatment plan, goals, interventions, evaluation results, observations and progress in EMR.
• Advocates for members and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team.
• Integrates a collaborative approach by attending interdisciplinary team meetings with nurses, physicians and patient care coordinators regarding patient care; collaborates with providers to determine acuity of behavioral health concerns.
• Utilizes professional knowledge and critical thinking to facilitate MD consultation on complex cases.
• Applies Nursing/Counseling/Social Work theory and interventions to improve member health and psychosocial functioning.
• Manages assigned case load efficiently.

Skills

Communication

HIPAA compliant

Microsoft Word

Interpersonal skills

Travel readiness

Education

RN license

Job description

UnitedHealth Group is seeking an experienced MB I NCM (Nurse Case Manager) to serve as a clinical liaison between the care delivery network and members, coordinating plans and services to meet health needs. The role includes evaluation visits across settings, care planning, and CMS-compliant documentation.

The position offers field visits, telework options, and a comprehensive benefits package. Willingness to travel locally up to 75% is required; valid driver’s license and transportation are