Field Case Manager RN – Orangeburg – Bamberg, SC

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere.

As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home.

We’re connecting care to create a seamless health journey for patients across care settings. 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 Field 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!

Location: Field based position throughout Anderson County, SC area.  You will be in the field going into member homes approximately 75% of the time.

Work Schedule: Monday through Friday 8am-5pm, hours may differ pending business/member needs

If you are located within the greater Anderson County, SC area, you will have the flexibility to work remotely*. This is a Field based position.

Primary Responsibilities:

• Perform initial review of consumer health records and current health status (e.g., health risk scores) to identify health risk and determine next steps
• Conduct initial and ongoing assessments utilizing nursing assessment skills in home setting
• Receive information from consumers about specific symptoms and questions
• Conduct interviews to understand cause and effect, gather or review health history for clinical symptoms, and determine health literacy
• Evaluate consumer data throughout the assessment process to identify inconsistencies and adherence to Evidence Based Guidelines from both the health care and psychosocial / socioeconomic dimensions of care
• Identify and prioritize gaps to develop plan of care and short and long-term goals to empower consumers to meet identified goals
• Determine consumer’s willingness to engage in plan of care and readiness for change
• Identify appropriate interventions and resources to meet gaps (e.g., psychosocial, transportation, long-term care) based on specific consumer needs from both the health care and psychosocial / socioeconomic dimensions of care
• Document the plan of care in appropriate EHR systems and enter data per specified format
• Maintain consumer engagement by establishing rapport, demonstrating empathy, and building a trusting relationship
• Collaborate with primary providers or multidisciplinary team to align or integrate goals to plan of care and drive consistent coordination of care
• Provide ongoing support for advanced care planning
• Reassess plan of care at appropriate intervals based on initial objectives, significant change of condition, or achievement of goals
• Understand and operate effectively / efficiently within legal/regulatory requirements
• Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results

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:

• Associate’s degree or higher in nursing
• Active, un-encumbered RN license to practice nursing in the state of South Carolina
• 1+ years of experience working with complex patient populations including multiple chronic diseases with diverse psychosocial backgrounds
• 1+ years of experience in a hospital, acute care or direct care setting
• Proven ability to type and have the ability to navigate a Windows based environment
• Access to reliable transportation
• Ability to travel to client and/or patient sites/homes within 60 miles of Orangeburg/Bamberg, SC approximately 75% of the time

Preferred Qualifications:

• BSN
• Certified Case Manager (CCM)
• 1+ years of experience working in home health or in-home setting
• Understanding of Medicare, Medicaid, and Health Plan benefit structures 
• Basic knowledge of computers and cell phones
• Proven comfortable working independently in a home-visit setting
• Proven effectively communicate with elderly and chronically ill patients and families
• Proven excellent organizational skills with the ability to multi-task and manage schedule     
• Proven excellent collaboration skills and ability to communicate with care team and physicians

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.