UnitedHealth Group Medicaid RN Case Manager - Baton Rouge, LA in Baton Rouge, Louisiana

As a RN Case Manager, you will drive positive outcomes by supporting a diverse member population with education, advocacy and the connections to the resources they need. What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

If you are located in Baton Rouge/Zachary/Denham Springs, LA, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Make outbound calls to assess members' current health status

  • Identify gaps or barriers in treatment plans

  • Provide patient education to assist with self-management

  • Interact with Medical Directors on challenging cases

  • Coordinate care for members

  • Make referrals to outside sources

  • Coordinate services as needed (home health, DME, etc.)

  • Educate members on disease processes

  • Encourage members to make healthy lifestyle changes

  • Document and track findings

  • Utilize Milliman criteria to determine if patients are in the correct hospital setting

  • Make “welcome home” calls to ensure that discharged member receive the necessary services and resources

  • Possible hospital visits with members

Required Qualifications:

  • Current, unrestricted RN license in the state of residence

  • Reliable transportation to travel to member homes or other locations within service delivery area

  • 3+ years clinical experience in a hospital, acute care, home health / hospice, direct care or case management

  • Computer / typing proficiency to enter/retrieve data in electronic clinical records; experience with email, Internet research, use of online calendars and other software applications

  • Ability to obtain CCM certification within 30 months of employment, if not currently held

  • Dedicated, distraction free work area in home for office

  • Access to high speed internet (DSL or Cable)

  • Availability to travel 50+ miles to meet with members in provider office/hospital/members’ home

  • Access to reliable transportation to work in field to meet with members

Preferred Qualifications:

  • Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action

  • Ability to communicate complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others

  • Case Management experience

  • Behavioral Health / Home Care / field based case management

  • Medicaid, Medicare, Managed Care experience

  • Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs

  • Bilingual skills

  • Experience in Home & Community based or Long Term Care services delivery

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*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 .