Care Manager RN - Per Diem
UnitedHealth Group · South Portland, ME · 4 days ago
RemoteRemoteHealthcare$28.27–$50.48/hrFull-time
About the role
The Care Manager RN - Per Diem provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team.
Responsibilities
- Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization review
- Assumes roles in assessment physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care, delegates to others as appropriate
- Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomes
- Interviews and collects patient specified data and chart review related to readmission and appropriately notifies care team
- Communicates telephonically and electronically with outpatient providers to enhance the continuum of care
- Integrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities, practice and governmental commercial payer guidelines
- Adheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies
- Assume responsibility for Health System required continued education and owns professional growth
- Communicate effectively in both oral and written form, as appropriate for the needs of the audience
- Perform tasks of a clinical nature within scope of assigned duties and clinical expertise
Requirements
- Associate's Degree (or higher) in Nursing
- Current, unrestricted RN license in the state of employment
- 1+ years of experience in a hospital, acute care, or direct care setting
- Intermediate level of proficiency to navigate Windows based environment and the ability to type
- Ability to work one Saturday, quarterly
Qualifications
- Bachelor's Degree in Nursing (BSN)
- Previous background in managed care
- Certified Case Manager (CCM)
- 1+ years of Case management experience
- Experience or exposure to discharge planning
Skills
- Intermediate level of proficiency to navigate Windows based environment and the ability to type
Benefits
- A comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
Pay
The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.