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Medi - Cal RN Case Manager Bilingual - Telecommute in San Diego, CA more...
Location:San Diego, CA
Company:Optum Operations
First posted:May 04, 2017 (last updated 3 weeks 5 days ago)

Theres energy and excitement here, a shared mission to improve the lives of others as well as our own. A passion for excellence you won't find anywhere else. We ask tough questions. We push ourselves and each other to find smarter solutions. The result is a culture of performance thats driving the health care industry forward. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Learn more, and start doing your lifes best work.(sm)

As a Case Management RN, you will drive positive outcomes by supporting a diverse member population with education, advocacy and the connections to the resources they need.
What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

View the Realistic Job Preview to learn more aspects of this job. Click here: (please use the apply button below)

***This is a work at home opportunity, but you must reside within the San Diego County service area and be anCalifornia resident***

Primary Responsibilities:

Make outbound calls to assess members' current health status
25% of the time you may be doing field work - you'll interact with members leaving the hospital - possibly with new medications or diagnoses. Or perhaps you'll perform home visits, assisting members with safe, effective transitions from care environments to where they live. You may also act as an intermediary between providers and members - serving in numerous roles, such as educator, evaluator, service coordinator, community resource researcher and more.
Identify gaps or barriers in treatment plans
Provide patient education to assist with self-management
Interact with Medical Directors on challenging cases
Coordinate care for members
Make referrals to outside sources
Coordinate services as needed (home health, DME, etc.)
Educate members on disease processes
Encourage members to make healthy lifestyle changes
Document and track findings
Utilize MCG criteria to determine if patients are in the correct hospital setting
Make welcome home calls to ensure that discharged member receive the necessary services and resources
Possible hospital visits with members

Required Qualifications:

Current, unrestricted RN license in the state of California
Reside in the state of California
3+ years clinical experience in hospital, acute care, home health / hospice, direct care or case management
Case Management experience
Reliable transportation to travel to member homes or other locations within service delivery area
Computer / typing proficiency to enter/retrieve data in electronic clinical records; experience with email, Internet research, use of online calendars and other software applications
Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
Ability to communicate complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
Preferred Qualifications:

Certification in Case Management (CCM must be obtained within 30 months of employment)
Home care / field based case management experience
Medi-Cal, Medicare, Managed Care experience
Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
Bilingual skills Spanish, Vietnamese
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
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: Case Manager, RN, Medicaid, Medi-Cal, Case Management, Bilingual, Clinical, Home Health, CCM, Managed Care, Medicare, San Diego, CA, California, Telecommute, Telecommuter, Work at Home, Telecommuting

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