RN Case Manager - HouseCalls - Remote - EST or CST - Compact

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - RN Case Manager
- House Calls
- Remote - EST or CST
- Compact license Required (2387123)

RN Case Manager
- House Calls
- Remote - EST or CST
- Compact license Required - 2387123

100% Remote

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum House Calls team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services.

This preventive care can help patients stay well ’re connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together.

We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with United Health Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come

The House Calls Clinical Support Team (HCCST) supports Advanced Practice Clinicians in the House Calls business by providing telephonic consultation to plan members post House Calls visit. This position is completely telephonic in a call center environment. Goals of the program include providing a one-time outreach to members for follow up post House Calls visit to provide education and clarification on any concerns raised during their House Calls visit.

The main objective of this program is to ensure successful transition of care from the House Calls Advanced Practice Clinician back to the members Primary Care Provider.

This team includes nurse care managers and social workers. The Nurse Care Manager (NCM) will report directly to the Manager/or Director of Clinical Operations of HCCST. The NCM interacts via telephonic consult with members and providers to assist with education and clarification on any concerns raised during the House Calls visit and ensure the member has/or assist in obtaining an appointment with the provider to transition care.

They work to ensure members receive quality customer service by answering questions, addressing concerns, providing education, providing resource information, and entering referrals.

You’ll enjoy the flexibility to work remotely
* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Perform telephonic outreach to members identified by the Advance Practice Clinician for specific referral related issues
• Ensure member has scheduled appointment with Primary Care Provider (PCP)/specialty provider; help scheduling appointment, if needed
• Refer members to internal departments such as Social Work, or Clinical Help Desk when appropriate
• Gather clinical information telephonically from patient/family
• Assist patients/members with urgent needs requiring acute intervention that arise during the call
• Identify triggers for hospitalization and barriers to meeting healthcare goals as they arise during the call
• Complete required documentation in compliance with auditing standards and policies
• Provide patient/family education on disease process and trigger management that arise during the call or are related to referral reasons
• Assist with connections to appropriate community resources if…