RN Utilization Case Manager — Home & Community Care

UnitedHealth Group; Milwaukee (WI); Hybrid; Confidential; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Job summary

UnitedHealthcare, a part of UnitedHealth Group, is seeking an Utilization Case Manager to serve Milwaukee County with some regional coverage. The role offers flexibility to work from the office and at home, with field-based work about 25% of the week. You must reside within commutable distance of Milwaukee, WI for this role.

Responsibilities include assessing health status, home visits, patient education, and coordinating care across services. Travel up to 25% is required.

Qualifications

• Current, unrestricted RN license in Wisconsin.
• 2+ years of hospital/acute care/direct care or home health case management experience.
• Proficient with Microsoft Office and EMR systems.

Responsibilities

• Make outbound calls to assess members' health status.
• Conduct face-to-face assessments in the member's home.
• Identify unmet needs and coordinate care for members.
• Document assessment details and apply state guidelines to service requests.
• Track findings and identify gaps or barriers in treatment plans.
• Educate members to assist with self-management.
• Collaborate with Medical Directors on challenging cases.
• Coordinate services (home health, DME, etc.).
• Refer to outside sources as needed.

Skills

Communication skills

Travel readiness

Patient education

Education

Registered Nurse (RN) license, Wisconsin

Tools

Microsoft Office

EMR systems

Job description

UnitedHealthcare, a part of UnitedHealth Group, is seeking an Utilization Case Manager to serve Milwaukee County with some regional coverage. The role offers flexibility to work from the office and at home, with field-based work about 25% of the week. You must reside within commutable distance of Milwaukee, WI for this role.

Responsibilities include assessing health status, home visits, patient education, and coordinating care across services. Travel up to 25% is required.