Care Manager RN

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.  

Provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with patients/caregivers and multidisciplinary healthcare teams. Facilitates appropriate length of stay (LOS), patient experience, and reimbursement for all patients. Provides leadership in patient-centered care coordination across the continuum. Develops safe discharge plans and arranges appropriate post-discharge services. Drives appropriate DRG length of stay, patient experience, and reimbursement. Promotes patient advocacy in an independent care model.

 This role is a full-time, onsite role at the Presque Isle, ME facility. 

Primary Responsibilities:  

• Maintains knowledge of care management, care coordination, authorizations, and regulatory requirements
• Assesses physical, psychosocial, and economic needs for transition of care planning
• Documents and validates data required to monitor and evaluate interventions and outcomes
• Communicates with outpatient providers to enhance the continuum of care
• Integrates performance improvement and customer service principles
• Adheres to hospital policies and state and federal regulations
• Performs other duties as assigned

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 license in the state of Maine
• 2+ years of experience in a hospital, acute care or direct care setting
• Ability to type and navigate a Windows based environment
• Proven solid communication skills; written, verbal, and in person
• Ability to develop and maintain positive relationships with internal and external customers
• Demonstrated accountability for decisions and behaviors, exercises critical thinking, clinical rationale, and ethical decision-making
• Willing to work on site at the hospital, Monday - Friday

Preferred Qualifications: 

• CCM, ACM other certification applicable to care management
• Experience in care management 
• Proven knowledge of care coordination, discharge and transition planning, and community resources

Pay 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.

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.

UnitedHealth 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.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.