Job Overview
UnitedHealthcare is a company that’s on the rise. We’re expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn’t about another gadget, it’s about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life’s best work.(sm)
Outpatient Case Manager is responsible for the management and coordination of Case Management services for members with complex needs and requiring complex service. The Outpatient Case Manager works directly with the member, provider(s), facilities, and other entities to ensure the most appropriate care is provided. The Case Manager manages members from all contracted product lines. The Case Manager assesses, plans, implements, coordinates, monitors, and evaluates the outcomes, ensuring options and services required to meet the member’s health needs are best utilized. The Case Manager provides education, advocacy, communication, and resource management and promotes quality, self-management, and cost-effective interventions and outcomes.
If you are located in Reno, NV, you will have the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
- Assess and interpret customer needs and requirements
- Review cases and analyze clinical information in conjunction with Medical Directors to determine the appropriateness of hospitalization
- Perform Clinician to Physician interaction to acquire additional clinical information or discuss alternatives to current treatment plans
- Escalate cases to the Medical Director for case discussion or peer-to-peer intervention, as appropriate
- Perform anticipatory discharge planning in accordance with the patient’s benefits and available alternative resources
- Collaborate with Medical peers on consideration of discharge planning needs
- Refer patients to disease management or case management programs
- Assist with the development of treatment plans
- Document activities according to established standards
- Identify solutions to non-standard requests and problems
- Solve moderately complex problems and/or conducts moderately complex analyses
- Work with minimal guidance; seeks guidance on only the most complex tasks
- Provide explanations and information to others on difficult issues
- Act as a resource for others with less experience
- Work with less structured, more complex issues
- Develop plans and supportive services for patients to achieve stability and adaptive functioning to become independent
- Support mental services and integrated substance abuse treatment, supporting medication management, symptoms management, rehabilitation, crisis stabilization, and psychosocial education on an outpatient basis
You’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.
Required Qualifications:
- LSW, LPN, RN, CPC
- Current, Unrestricted license
- Knowledge of patient care delivery in a managed care environment
- Basic knowledge of both state programs and community-based services
- Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance
Preferred Qualifications:
- 2+ years of case management experience and CCM certification
- Inpatient experience or experience working in a behavioral health setting
- Dual diagnosis experience with mental health and substance abuse
- Demonstrate critical thinking skills as a case manager and able to formulate innovative plan of care for complex cases
- Experience working in an environment that requires coordinating benefits and utilizing multiple groups and resources for patients
- Proficient in navigating and charting in Electronic Medical Record systems
- Intermediate computer skills, including experience with Microsoft Word and ability to navigate in a Windows environment
- Demonstrates initiative toward problem solving skills
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we’re presented with an opportunity to make a difference on a scale we couldn’t imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you’ll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You’ll help write the next chapter in the history of health care. And you’ll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life’s best work.(sm)
Nevada Residents Only: The salary range for Nevada residents is $60,000 to $106,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity 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.
UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.
