Telephonic Case Manager - Remote in Michigan

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.

In this Telephonic Case Manager role, you will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs.

If you are located within the state of Michigan, you will have the flexibility to be 100% telecommute* as you take on some tough challenges.

Primary Responsibilities:

• Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
• Manage the care plan throughout the continuum of care as a single point of contact
• 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 health care team
• Provide telephonic care management to members on caseload including specialized populations such as the Justice Involved population
• Support Care Management efforts to outreach members recently discharged from the hospital to determine needs and prevent avoidable readmissions
• Work with Pharmacy Lock-in members, which includes Care Management support, pharmacy change requests, and periodic determination of ongoing member eligibility for the program
• Present and participate in Interdisciplinary rounds
• Collaborate with Medical Directors regarding member needs and complex issues
• Support Quality and Population Health initiatives as requested
• Participate in work groups to assist with processes and workflows

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:

• Unrestricted RN license or LMSW in the State of Michigan
• 4+ years of experience working within the community health setting in a health care role/clinical health care role
• 1+ years of experience working with MS Word, Excel and Outlook
• 1+ year of community mental health experience OR 1+ year of experience working with individuals with severe mental health conditions

Preferred Qualifications:

• Case Management experience including Certification in Case Management
• Background in managing populations with complex medical or behavioral needs
• Telephonic Case Management experience
• Experience with electronic charting
• Experience with arranging community resources
• Experience in Utilization Management, Home Health and/ or Discharge Planning
• Medicaid, Medicare, Managed Care experience
• Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
• Experience using multiple systems to retrieve member data
• Problem solving experience; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
• Experience in long-term care, home health, hospice, public health or assisted living

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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