Remote RN Case Manager: Care Navigator

UnitedHealth Group; Spokane (WA); Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group is seeking a Telephonic RN Case Manager within the Optum Care at Home program. This role focuses on high-volume, phone-based care coordination for members with complex medical and social needs, delivering person-centered plans and facilitating safe transitions across settings.

The RN will assess needs, develop care plans, coordinate Medicaid/Medicare services, educate members, and document in electronic health records while maintaining licensure and compliance.

Qualifications

• Active, unrestricted RN license or multistate license with authority to practice for WA/CO by start date.
• 2 years of professional RN experience.
• Experience coordinating care for patients or members with complex or high-risk needs.
• Experience with Medicaid LTSS or similar programs.
• Experience in case management or care coordination.
• Proficiency documenting in electronic health records or care management platforms while on calls.
• Driver’s license and reliable transportation.

Responsibilities

• Conduct comprehensive telephonic assessments of members’ medical, behavioral health, functional, psychosocial, caregiver and environmental needs.
• Develop, implement and reassess individualized, person-centered care plans.
• Coordinate care across Medicare, Medicaid, primary/specialty care and home health services.
• Identify gaps in care and barriers to treatment and connect members with resources.
• Facilitate safe transitions between hospitals, SNFs, home health and residence.
• Assess changes in condition and escalate as needed with clinical teams.
• Respond to and manage member escalations with stakeholders.
• Provide education on conditions, medications and self-management.
• Advocate for members in care planning and service delivery.
• Support advance care planning discussions and connect to resources.
• Document assessments, plans and outcomes in EHR and care management systems.
• Use evidence-based standards and regulatory requirements in coordinating services.
• Maintain RN licensure and related credentials.

Skills

RN license

2 years RN experience

telephonic care coordination

EHR navigation

driving

Tools

Electronic Health Records

Care management software

Job description

UnitedHealth Group is seeking a Telephonic RN Case Manager within the Optum Care at Home program. This role focuses on high-volume, phone-based care coordination for members with complex medical and social needs, delivering person-centered plans and facilitating safe transitions across settings.

The RN will assess needs, develop care plans, coordinate Medicaid/Medicare services, educate members, and document in electronic health records while maintaining licensure and compliance.