RN Case Manager - ED - Remote in UT

UnitedHealth Group; Utah; Remote; USD 73,000 - 130,000; Full time

Job summary

UnitedHealth Group's Optum division in Draper, UT seeks a Registered Nurse Case Manager - ED to provide telephonic proactive care coordination for members with frequent ED use, aimed at reducing avoidable visits and hospital admissions through early intervention and engagement.

You will conduct assessments, coordinate care, reinforce PCP follow-ups, educate on disease management, and connect members with appropriate programs while documenting all actions in accordance with regulatory

Qualifications

• Bachelor's degree in nursing (BSN preferred).
• 3+ years of clinical nursing experience, preferably in acute care, care or case management.
• Current, unrestricted RN license in Utah.

Responsibilities

• Deploy RN case management support for high-risk and frequent ED utilizers.
• Conduct comprehensive assessments of clinical, psychosocial, behavioral health, and social needs.
• Provide proactive outreach, care coordination, and member engagement.
• Encourage PCP engagement and timely follow-up appointments.
• Educate members and caregivers on disease management and adherence.
• Identify root causes of ED utilization and address care gaps.
• Connect members to Complex Case Management, Disease Management, Behavioral Health, and community resources.
• Use ED diversion strategies to promote appropriate care settings.
• Document assessments, interventions, and outcomes per requirements.

Skills

Care coordination

Patient engagement

Education delivery

Telephonic case management

Proactive outreach

Risk assessment

Education

Bachelor's degree in nursing

BSN preferred

Job description

About This Role

The RN Case Manager - ED provides telephonic proactive case management services to members with frequent Emergency Department utilization, focusing on reducing avoidable ED visits and hospital admissions through early intervention, care coordination, and patient engagement.

Highlights

• Pay: $72,800 - $130,000/year
• Location: Draper, UT
• Brand/Division: Optum
• Schedule: Full Time, Day shift

What You'll Do

• Deploy RN case management support for identified high-risk and frequent ED utilizers within assigned markets
• Conduct comprehensive assessments to identify clinical, psychosocial, behavioral health, and social determinants of health needs
• Deliver proactive outreach, care coordination, and longitudinal member engagement to promote self-management and care plan adherence
• Reinforce primary care provider (PCP) engagement and facilitate timely follow-up appointments
• Provide education to members and caregivers regarding disease management, symptom recognition, medication adherence, and appropriate care settings
• Identify and address root causes of ED utilization, including care gaps, access barriers, social needs, and behavioral health concerns
• Connect members to appropriate programs and services, including Complex Case Management, Disease Management, Behavioral Health, Social Work, and community-based resources
• Utilize ED diversion strategies to support treatment in the most appropriate setting and prevent avoidable hospital admissions
• Monitor member progress and adjust interventions based on changing healthcare needs and risk factors
• Document all assessments, interventions, care plans, and outcomes in accordance with organizational and regulatory requirements

Requirements

• Education: Bachelor's degree in nursing (BSN preferred)
• Experience: 3+ years of clinical nursing experience, preferably in acute care, care management, case management, utilization management, discharge planning, or transitional care
• Licenses & Certifications: Current, unrestricted Registered Nurse (RN) license in Utah

About UnitedHealth Group

UnitedHealth Group is a leading healthcare provider committed to delivering exceptional patient care. They are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable, and more connected for the people they serve.