About this opportunity
UnitedHealth Group lists this Case Manager RN opportunity in bangor, Maine. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Requisition number:
nJob category: Nursing
nOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
nResponsibilities:
nnnMaintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization review
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nnAssessment of physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care; delegates to others as appropriate
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nnDocuments, verifies, and validates specific data required to monitor and evaluate interventions and outcomes
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nnInterviews and collects patient specified data and chart review related to readmission and appropriately notifies care team
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nnCommunicates telephonically and electronically with outpatient providers in an effort to enhance the continuum of care
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nnIntegrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities; practice and governmental commercial payer guidelines
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nnAdheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies
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nnAssumes responsibility for NL EMMC required continued education and owns professional growth
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nnProvides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients / caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care
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nnDrives to appropriate DRG length of stay, patient experience, and reimbursement for all patients
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nnPromotes patient advocacy in an independent care model
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nnPerforms other duties as assigned or required
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n nYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in
nRequired Qualifications:
nnnAssociates degree
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nnCurrent, unrestricted RN license in the state of employment
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nn3+ years of experience in a hospital, acute care or direct care setting
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nnMust be able to type and have the ability to navigate a Windows based environment
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n nPreferred Qualifications:
nnnBSN
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nnBackground in managed care
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nnCase management experience
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nnACM, CCM or other certification applicable to utilization management
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nnExperience or exposure to discharge planning
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nnExperience in utilization review, concurrent review or risk management
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nnPrevious experience in a telephonic role
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nnAnswer the call to use your diverse knowledge and experience to make health care work better for our patients. Join us and start doing your life's best work
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n nPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
nAt UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
nDiversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
nUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
n#RPO,#RED
Worksite address
bangor, ME, 04401, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.