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Case Manager, RN - Remote

Company: UnitedHealth Group
Location: Los Angeles
Posted on: November 19, 2023

Job Description:

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. -
Optum's Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.
Position in this function is responsible for providing moderately complex telephonic nursing assessment, evaluation, and advice to patients through established and approved telehealth protocols with physician oversight.
If you have a California RN license, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:

  • Consistently exhibits behavior and communication skills demonstrating Optum's commitment to superior customer service, including quality, care, and concern with every internal and external customer
  • Performs comprehensive telephonic patient assessment, evaluation, and advice while meeting production standards
  • Follows established clinical protocols/guidelines and provides appropriate patient instructions
  • Directs patient to appropriate levels of care based on assessment within Optum's guidelines
  • Documents authorizations for vendors and/or outside services as appropriate
  • Instructs patients on procedural preparations
  • Documents and maintains records of telephonic interactions
  • Completes medical documentation of telephonic assessment and disposition in Telehealth Record
  • Notifies pharmacies of new prescriptions and authorizations of refills as ordered by the clinician or via pharmacy protocols
  • Translates oral information into concise and accurate written documentation using standard medical guidelines and abbreviations
  • Manages own work queues
  • Recognizes financial, medical, and legal risks based on data collected during customer interactions and follows appropriate procedures
  • Expedites emergency calls as needed
  • Accesses Language Line for non-English patients as needed

    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:

    • Graduation from an accredited school of nursing
    • Active, unrestricted Registered Nurse license through the State of California
    • Basic Life Support (BLS)for healthcare providers through the America Heart Association or ability to obtain at the time of hire -

      Preferred Qualifications:

      • BSN
      • ESI (Emergency Severity Index) Certification
      • 2+ years of experience working as a Registered Nurse
      • ER/critical care/Pediatrics/Med/Surg

        California Residents Only: The hourly range for California residents is $27.07 to $53.08 per hour. 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 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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. - -
        OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. -

Keywords: UnitedHealth Group, Los Angeles , Case Manager, RN - Remote, Executive , Los Angeles, California

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