RN Utilization & Care Coordination Specialist (Hybrid)

ISHE; Milwaukee (WI); Hybrid; USD 60,000 - 107,000; Full time

Benefits offered by this job

Benefits package

Equity stock purchase

401k contribution

Job summary

UnitedHealthcare is seeking an Utilization Case Manager to serve Milwaukee County with some regional travel, offering flexible work from office or home setups and field-based work about 25% of the week. The role requires residing within commutable distance of Milwaukee, WI and surrounding areas, and focuses on coordinating care, patient education, and bridging gaps in treatment plans.

You will perform home visits, document findings, and collaborate with Medical Directors to ensure compliant,

Qualifications

• Current, unrestricted RN license in Wisconsin.
• 2+ years of experience in a hospital setting, acute care, direct care, or Home Health Case Manager.
• Basic level of experience with Microsoft Office and EMR applications.
• Reliable transportation to travel to member homes within the geographical area.
• Willing to travel up to 25% to member homes.

Responsibilities

• Making outbound calls to assess members' current health status.
• Conducting face-to-face assessments in the member's home.
• Assisting members in identifying unmet needs.
• Documenting assessment details and applying State guidelines to service requests.
• Documenting and tracking findings.
• Identifying gaps or barriers in treatment plans.
• Providing patient education to support self-management.
• Interacting with Medical Directors on challenging cases.
• Coordinating care for members.
• Making referrals to outside sources.
• Coordinating services as needed (home health, DME, etc.).
• Educating members on disease processes.
• Encouraging members to make healthy lifestyle changes.

Skills

RN license Wisconsin

Home Health Case Management

Microsoft Office

Travel readiness

Tools

EMR systems

Microsoft Office

Job description

UnitedHealthcare is seeking an Utilization Case Manager to serve Milwaukee County with some regional travel, offering flexible work from office or home setups and field-based work about 25% of the week. The role requires residing within commutable distance of Milwaukee, WI and surrounding areas, and focuses on coordinating care, patient education, and bridging gaps in treatment plans.

You will perform home visits, document findings, and collaborate with Medical Directors to ensure compliant,