Remote RN Case Manager — Care Transitions Leader

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

Benefits offered by this job

Comprehensive benefits package

Incentive programs

Equity stock purchase

401k contribution

Job summary

UnitedHealth Group's Optum unit is seeking an experienced RN Case Manager to coordinate transitions of care for ED discharges across the U.S. This remote role adapts as programs scale, ensuring proactive outreach and evidence-based care coordination with hospitals, PCPs, and home care resources.

You will partner with ED and outpatient teams, manage a caseload, document accurately in systems, and maintain licensure. The role emphasizes quality improvement and regulatory adherence.

Qualifications

• Current, unrestricted Multistate RN license.
• 4+ years diverse clinical experience with acutely ill patients.
• 1+ year experience in the Emergency Department.
• Knowledge of utilization management, quality improvement, and discharge planning.
• Rapid acuity-based clinical prioritization.
• Recognizing early signs of clinical deterioration.
• Identifying patients at risk for ED return visits or avoidable bounce-backs.
• Credibility with ED physicians and staff.
• Understanding ED workflow, throughput, and provider decision-making.

Responsibilities

• Collaborates with ED and outpatient care teams to establish an individualized transition plan.
• Serves as clinical liaison with hospital staff and performs transition of care for ED discharges.
• Performs expedited, standard, concurrent, and retrospective clinical reviews.
• Communicates discharge needs and plan to members and families.
• Monitors real-time ADT feeds to assess discharge coordination opportunities.
• Conducts transition outreach post-ED discharge to confirm plan completion.

Skills

Clinical expertise

Emergency Department experience

Utilization management

Discharge planning

HIPAA compliance

Acute care experience

Education

RN license (multistate)

Job description

UnitedHealth Group's Optum unit is seeking an experienced RN Case Manager to coordinate transitions of care for ED discharges across the U.S. This remote role adapts as programs scale, ensuring proactive outreach and evidence-based care coordination with hospitals, PCPs, and home care resources.

You will partner with ED and outpatient teams, manage a caseload, document accurately in systems, and maintain licensure. The role emphasizes quality improvement and regulatory adherence.