Optum
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
As a Discharge Care Manager (Central or Eastern Region) at UnitedHealth Group, you will be responsible for implementing day-to-day telephonic case management interventions for identified high risk members. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. The Discharge Care Manager (DCM) will coordinate and document the discharge plan in collaboration with other key clinical care team members. The DCM will also follow the member while in the acute inpatient setting. If you are located in Central or Eastern Time Zone, you will have the flexibility to work remotely* as you take on some tough challenges.
Required Qualifications: Bachelor of Science in Nursing Current, unrestricted Compact RN license in the State of residence and either hold or be willing to obtain MI State RN Licensure 5+ years of recent experience in the inpatient acute setting 2+ years of experience of discharge planning Experience working with multiple health insurance products (Medicaid, Medicare, Commercial) within the insurance industry, including regulatory and compliance requirements Proficient in typing skills and software applications that includes, but is not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint and Microsoft Outlook Designated work space and access to install secure high speed internet via cable/DSL in your home Permanent residence within the U.S. Central or Eastern Standard Time zone Preferred Qualifications: Case Management Certification InterQual/MCG Guidelines or other nationally recognized practice guidelines Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance, and achieve targets Proven problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action Proven excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
Evaluation of member discharge needs including delays in care and readmission prevention plan Collaboration with providers and members to coordinate care post discharge Participate in rounds with the Medical Director to discuss cases as needed Identification of internal or community-based program support or resources Coordination with the facility Discharge Planner to ensure post hospital services are arranged prior to the member being discharged Assist with coordination of difficult cases needing placement in an alternate level of care facility Documentation of discharge activities as outlined in standard operating procedures and data entry strategies Participate in team meetings, education discussions and related activities Works collaboratively with team members in a matrix environment to ensure an end-to-end positive experience for members, providers and care teams
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