About this opportunity
UnitedHealth Group lists this Utilization Case Manager RN - In-Home Services - Milwaukee, WI opportunity in milwaukee, Wisconsin. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Requisition number:
nJob category: Nursing
nAt UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
nThe Utilization Case Manager serves Milwaukee County with occasional coverage in surrounding counties. This position offers the flexibility to work from the office and at home with field-based work in the local community approximately 25% of the work week.
nThis role requires you to reside within a commutable distance of Milwaukee, WI and surrounding areas.
nPrimary Responsibilities:
nnnMaking outbound calls to assess members' current health status
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nnConducting face to face assessments in the member's home
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nnAssisting members in identifying unmet needs
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nnDocumenting assessment details and applying State guidelines to requests for services
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nnDocumenting and tracking findings
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nnIdentifying gaps or barriers in treatment plans
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nnProviding patient education to assist with self- management
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nnInteracting with Medical Directors on challenging cases
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nnCoordinating care for members
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nnMaking referrals to outside sources
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nnCoordinating services as needed (home health, DME, etc.)
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nnEducating members on disease processes
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nnEncouraging members to make healthy lifestyle changes
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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:
nnnCurrent, unrestricted RN license in the State of Wisconsin
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nn2+ years of experience in a hospital setting, acute care, direct care experience or experience as a Home Health Case Manager
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nnBasic level of experience with Microsoft Office and other electronic medical record applications
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nnReliable transportation to travel to member's homes within the geographical area
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nnWilling to travel up to 25% to member homes
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n nPreferred Qualifications:
nnnHome Health Case Management experience
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nnExperience in utilization review, concurrent review and / or risk management
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nnExperience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
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nnExperience with the Personal Care Screening Tool (PCST) or the Long Term Care Functional Screen (LTCFS)
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nnA background in Medicaid / Medicare managed care
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nnBilingual Spanish
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nnBilingual Hmong
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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 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ
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.
nUnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
nUnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Worksite address
milwaukee, WI, 53244, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.