UnitedHealthcare
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.
As a Maternal/Child Registered Nurse Case Manager, you will act in a liaison role with Medicaid members ages birth to seventeen and their families to ensure appropriate care is accessed as well as to provide home and social assessments and member and family education. RN Case Manager will coordinate care that focuses on supporting members’ medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improve quality of care. Interest in learning to work with medically complex patients that include the NICU, Private Duty Nursing (PDN), and Pediatric populations is important for this role. Expect to spend up to 25% of your time in the field visiting our members and families in their homes or in long-term care facilities. You’ll need to be flexible, adaptable and, above all, patient in all types of situations. If you reside in the state of WA, preferably the Greater Seattle or Tacoma area, you will have the flexibility to work remotely* as you take on some tough challenges.
Required Qualifications: Current, unrestricted RN licensure in the state of Washington 2+ years of NICU and/or Pediatric clinical experience 1+ year of experience with MS Office, including Word, Excel, Outlook, and TEAMs Reliable transportation and the ability to travel up to 25% within Washington State to meet with members and providers. *Travel time can change depending on the needs of the business Reside in the state of Washington Preferred Qualifications: CCM certification 1+ year of Case Management experience coordinating care for individuals with complex needs Experience working in team-based care Experience with Maternal Health Bilingual: English and Spanish Proven background in Managed Care Physical Requirements: Ability to transition from office to field locations multiple times per day Ability to navigate multiple locations/terrains to visit employees, members and/or providers Ability to transport equipment to and from field locations needed for visits (ex. laptop, etc.) Ability to remain stationary for long periods of time to complete computer or tablet work duties All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person-centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health Support proactive discharge planning and manage/coordinate care transition Advocate for members and families as needed to ensure the member’s needs and choices are fully represented and supported by the health care team
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