Transplant Utilization Management RN – Remote

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.

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 Transplant Case Manager RN with UnitedHealth 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. Ready for a new path? Apply today! Shift: Monday – Friday, 8:00am – 5:00pm in your time zone. This position is approximately 75% Utilization Management and 25% Case Management You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Perform utilization management for transplant services for Medicare Advantage and Dual eligible members Perform utilization review of inpatient cases Direct providers and members to contracted provider network and facilities Coordinate with the transplant facility through all phases of the transplant process, from initial evaluation to 365 days post-transplant, ensuring seamless communication and comprehensive patient care Make outbound calls to assess members’ current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self-management Make referrals to outside sources Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You’ll need to be efficient, productive and thorough through telephonic interaction Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes