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.

On the UHC Community & State Complex Care Management team, this TX Registered Nurse will address efforts focused on medical, behavioral, and social determinants of health factors that improve the well-being of individuals, families, and communities. Within the scope of nursing practice, this RN will be an essential element of an Integrated Care Model by relaying pertinent information about the member needs and advocating for the best possible care available.

• Generally, work is self-directed and not prescribed
• Works with less structured, more complex issue
• Serves as a resource to others.

He/she/they will telephonically work directly with a diverse population of members to assist with unmet needs, closing gaps in care, reducing risk for ER and hospital utilization, identifying appropriate referral needs, and providing education on disease management and preventive health care to empower patients to manage their chronic health conditions.

If you are located in Texas, you will have the flexibility to work remotely* as you take on some tough challenges with the travel up to 25% of time in the field, visiting our members in their homes, long term care (LTC), or other approved facilities

Primary Responsibilities:

• Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care
• Utilize both company and community-based resources to establish a safe and effective case management plan for members
• Collaborate with patient, family, and healthcare providers to develop an individualized plan of care
• Identify and initiate referrals for social service programs, including financial, psychosocial, community, and state supportive services
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members
• Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the healthcare team
• Utilize approved clinical criteria to assess and determine appropriate level of care for members
• Document all member assessments, care plan and referrals provided
• Participate in Interdisciplinary team meetings and Utilization Management rounds and provide information to assist with safe transitions of care
• Understand insurance products, benefits, coverage limitations, insurance, and governmental regulations as it applies to the health plan
• Understand role and how it affects utilization management benchmarks and quality outcomes
• You’ll need to be flexible, adaptable and, above all, patient in all types of situations

What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at: http://uhg.hr/uhgbenefits

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:

• Active, unrestricted RN license in the state of Texas
• 2+ years of experience working within the community health setting in a health care role
• Intermediate level of proficiency in MS Office (Word, Excel, PowerPoint, Outlook, Teams)
• Intermediate level of proficiency with technology resources (computers/mobile devices, Internet, social media platforms & networks, software applications, virtual presence, etc.)
• Have a designated quiet workspace and access to install secure high-speed internet via cable/DSL in home
• This is a non-exempt/hourly paid role. Must be willing to work core business hours Mon-Fri, 8:00am – 5:00pm (CT) and overtime, when required at the request of the business
• Expect to travel up to 25% of time in the field, visiting our members in their homes, long term care (LTC), or other approved facilities
• Live within commutable distance to a TX UnitedHealthcare office

Preferred Qualifications:

• Certified Diabetes Care and Education Specialist or Registered Dietician
• Background in managing populations with diabetes
• BSN – Bachelor of Science in Nursing
• 4+ years diversified clinical nursing experience, including medical/surgical nursing, case management or home care
• Experience with electronic charting
• Bilingual
• Experience collaborating with communities of all different ethnicities, cultural backgrounds, diverse populations and/or underserved communities
• Experience with arranging community resources
• Background in managing populations with complex medical or behavioral needs
• Demonstrated knowledge of Medicaid
• Proficiency in CMS marketing rules and regulations
• Behavioral health experience
• Field based work experience

Soft Skills:

• Solid, interpersonal, relationship-building skills
• Able to communicate effectively written and verbal in a professional manner
• Ability to work in a self-directed manner within a fast-paced, deadline-driven environment
• Proactively seeks guidance on complex tasks, as needed
• Client focus and ability to adapt style and approach to customer preferences
• Problem resolution and time management skills
• Remain flexible, adaptable, and patient in all types of situations

*All Telecommuters 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.

#RPO #Yellow