RN Case Manager - Hilo, HI - Independent, field-based role! at Hilo

Description:

For those who want to invent the future of health care, heres your opportunity. Were going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your lifes best work.(sm) UnitedHealthcare Community & State has an immediate need for RN Case Managers to make home visits and conduct assessments on patients throughout the Hilo area. Responsibilities for Case Managers include:

Making outbound calls andhome visitsto assess members current health status
Identifying gaps or barriers in treatment plans
Providing patient education to assist with 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
Documenting and tracking findings
Utilizing Milliman criteria to determine if patients are in the correct hospital setting
Making welcome home calls to ensure that discharged member receive the necessary services and resources

Qualifications:

Current, unrestricted RN license in the State of Hawaii
A minimum of 2 years ofexperience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
Demonstrated proficiencywith Microsoft Word and Excel,including the ability to navigate a Windows environment
Current, unrestricted Drivers License; reliable transportation; and proof of automobile insurance
Experience in a community-based setting, such as Hospice or Home Health
DESIRED ASSETS:

Bachelors Degree
A background in managed care
Case Management experience
Certified Case Manager (CCM)
Experience/exposure with discharge planning
Experience in utilization review, concurrent review and/or risk management
UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. If youre ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach. This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Keywords: RN, Nurse, Registered Nurse, Case Manager, Case Management, Milliman, Hospice, Home Health, Medicaid, Medicare
Country: USA, State: Hawaii, City: Hilo, Company: UnitedHealth Group.