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Inpatient RN Case Manager - Las Vegas, NV - $5K Sign On Bonus for External Candidates

Company: UnitedHealth Group
Location: Las Vegas
Posted on: November 22, 2021

Job Description:

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)Are you ready for your next challenge? Discover it here at UnitedHealth Group and help us reinvent the health system. We're going beyond basic care, providing integrated health programs with a member-centric focus. The challenge is ensuring we deliver the right care at the right time. When you join us as an Onsite RN Case Manager, you'll be making a difference in peoples' lives and will be responsible for discharge planning, improved transitions of care, and utilization management of hospitalized health plan members. You will ensure patients receive quality medical care in the most appropriate setting.**Candidates must be flexible to work onsite at a hospital in the Las Vegas and Henderson area.**If you are located in Las Vegas, NV, you will have the flexibility to telecommute* as you take on some tough challenges.Primary Responsibilities:

  • Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
  • Utilize both company and community based resources to establish a safe and effective case management plan for hospitalized members
  • Collaborate with patient, family, and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge plan
  • Communicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized members
  • Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team
  • Utilize approved clinical criteria to assess and determine appropriate level of care for hospitalized members
  • Understand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health plan
  • Accountable to understand role and how it affects utilization management benchmarks and quality outcomes
  • Provides health education and coaches consumers on treatment alternatives to assist them in best decision making
  • Supports consumers in selection of best physician and facility to maximize access, quality, and to manage heath care cost
  • Coordinates services and referrals to health programs
  • Prepares individuals for physician visits
  • Assesses and triages immediate health concerns
  • Manages utilization through education
  • Identifies problems or gaps in care offering opportunity for intervention
  • Assists members in sorting through their benefits and making choices
  • Takes in-bound calls and places out-bound calls as dictated by consumer and business needs
  • Special projects, initiatives, and other job duties as assigned
  • Work completed in Sub - Acute facilities or Acute Hospital settings
  • Occasional driving up to one (1) hour daily for regular employees per diem employees will drive less than one hour daily and are not subject to the driving requirementsThis role performs the following case management skills on a daily basis:
    • Perform patient assessment of all major domains using evidence based criteria (physical, functional, financial and psychosocial)
    • Develop individualized discharge plans that involve provider, patient, and caregiver goals for successful transitions of care
    • Implement discharge plan involving health care resources across the continuum
    • Monitor and report variances that may challenge timely quality careYou'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:
      • Registered Nurse with active unrestricted license in the State of Nevada
      • 3+ years of acute hospital experience in one or more of the following areas: med-surg, ER, ICU or IMC / stepdown
      • Basic to intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word
      • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.Preferred Qualifications:
        • Bachelor's degree
        • CCM certification or ability to obtain within 2 years of employment
        • Case management / utilization review experience
        • Knowledge of Interqual or MCG
        • Experience in a managed care organization
        • Proficient in Microsoft Excel and PowerPointUnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination statusCareers 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)
          • All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.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.Job Keywords: Inpatient RN Case Manager, RN, Nurse, Case Manager, ER, IMC, Med-surg, ICU, Claims, MCG, Milliman, Appeals, Grievances, CCM, Medicaid , Public Health, Care Coordination, Case Management, Utilization Review, Prior Authorization, Discharge Planning, Medical Adjudication, Managed Care, Med-surg, Las Vegas, NV, Nevada, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

Keywords: UnitedHealth Group, Las Vegas , Inpatient RN Case Manager - Las Vegas, NV - $5K Sign On Bonus for External Candidates, Healthcare , Las Vegas, Nevada

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