RN Case Manager - HouseCalls - Remote - EST or CST - Compact license Required

UnitedHealth Group; Maryland; Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group is seeking a dedicated RN Case Manager - HouseCalls in Columbia, MD. You will perform telephonic outreach, help coordinate appointments, and connect patients with social work and clinical resources while documenting all interactions according to policy.

The role requires an active Compact RN license, 3+ years RN experience, and 1+ year remote call center work. A valid undergraduate degree is required for consideration.

Qualifications

• Current, unrestricted Compact RN license in the state.
• Licensure in assigned states must be obtained within 6 months of hire.
• 3+ years of clinical RN experience in hospital/acute care/home health/direct care/case management.
• 1+ year remote call center experience.

Responsibilities

• Perform telephonic outreach to members identified by the Advance Practice Clinician for referral issues.
• Ensure member has scheduled appointment with PCP or specialty provider; assist scheduling if needed.
• Refer members to internal departments such as Social Work or Clinical Help Desk.
• Gather clinical information telephonically from patient/family.
• Assist patients with urgent needs requiring acute intervention during calls.
• Identify hospitalization triggers and barriers to healthcare goals during calls.
• Complete required documentation in line with auditing standards.
• Provide education on disease processes and trigger management during calls or related to referrals.
• Assist with connections to appropriate community resources when needed.
• Maintain confidentiality of legal and ethical issues.

Skills

RN experience

Remote call center experience

Disease management education

Education

Undergraduate Degree

Current, unrestricted Compact RN license

Job description

About This Role

The RN Case Manager - HouseCalls position at UnitedHealth Group involves providing telephonic consultation and support to members after their HouseCalls visit. This role is ideal for those who want to make a significant impact on patient care through education and resource connection in a remote setting.

Highlights

• Pay: $60,200 - $107,400/year
• Location: Columbia, MD
• Brand/Division: Optum Home & Community Care
• Schedule: Full Time, Day shift
• Residency: Must reside in the U.S.

What You'll Do

• Perform telephonic outreach to members identified by the Advance Practice Clinician for specific referral related issues
• Ensure member has scheduled appointment with Primary Care Provider (PCP)/specialty provider; help scheduling appointment, if needed
• Refer members to internal departments such as Social Work, or Clinical Help Desk when appropriate
• Gather clinical information telephonically from patient/family
• Assist patients/members with urgent needs requiring acute intervention that arise during the call
• Identify triggers for hospitalization and barriers to meeting healthcare goals as they arise during the call
• Complete required documentation in compliance with auditing standards and policies
• Provide patient/family education on disease process and trigger management that arise during the call or are related to referral reasons
• Assist with connections to appropriate community resources if needed
• Understand and maintain confidentiality of legal and ethical issues

Requirements

Education:

• Undergraduate Degree required

Experience:

• 3+ years of clinical experience as a Registered Nurse in a hospital, acute care, home health/hospice, direct care, or case management position
• 1+ years remote call center experience

Licenses & Certifications:

• Current, unrestricted Compact RN (Registered Nurse) license in the state
• Additional licensure in assigned states must be obtained within 6 months of hire

About UnitedHealth Group

UnitedHealth Group is a leading healthcare provider committed to delivering exceptional patient care. They focus on creating integrated care models that address individuals' physical, mental, and social needs, ensuring that patients can access and navigate care anytime and anywhere.