HSS Complex Care Manager RN – Central, VA Market

At 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. 

The Complex Care Manager, RN will be managing complex members and is responsible for facilitating, promoting and advocating for the enrollees’ ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients (High risk stratification).   Care Manager will manage the care of members in their homes or other community settings by completing telephonic and or face to face health risk assessments and coordinating patient care, focusing on disease management and keeping members healthy and independent.  The care manager will provide clinical and medical management services, including care management, health assessments, interventions, and discharge planning.  Work is generally self-directed and not prescribed; so, it will be important to function in a less structured work environment.

 If you reside within state of VA, you will have the flexibility to work remotely* as you take on some tough challenges.

    

Primary Responsibilities: 

• Engaging members/families telephonically and/or face to face to coordinate services, community resources, and treatment needs
• Delivering a holistic approach to coordinated care based on the member’s needs using a person-centered philosophy
• Identifying early risk factors and conducting ongoing assessments and documenting in an electronic file
• Creating, reviewing and revising care plans and focusing on a holistic approach  
• Functioning as an advocate for member 
• Collaborating with the member’s PCP to deliver and coordinate necessary services
• Building relationships with members and their families; assisting them with coordination of health choices
• Ensuring cases are documented in a timely manner
• Coordination with other state agencies, community resources and providers
• Act as the primary point of contact for Members and the Interdisciplinary Care Team (ICT) 

  

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: 

• Current, unrestricted RN licensure in the state of Virginia
• 2+ years recent experience in case management, home care, long term care and/or experience in acute or rehab care setting 
• 1+ years of experience directly working with individuals with complex medical or behavioral needs 
• Basic level of proficiency in Microsoft Office suite applications (Word, Excel, Outlook/Email, Internet), including the ability to type and talk at the same time and toggle between multiple applications 
• Willingness to travel (up to 25%) within a designated geographical region of Virginia for home/site visits, as well as access to reliable transportation and proof of automobile insurance for vehicle being used 
• Proven ability to perform other delegated duties as assigned
• Broadband internet capability from home office

 

Preferred Qualifications:

• CCM certification
• Managed care/case management experience
• Experience with Medicare and/or Medicaid
• Experience with complex populations

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy  

  

At 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.    

 

  

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.