Clinical Care Manager (CCM), RN - Remote

About the Role

As a Clinical Care Manager (CCM) at UnitedHealthcare Global Emergency Response and Assistance Center, you will serve as a key member of the team, utilizing evidence-based practice to assess global travelers' medical care needs. You will evaluate treatment plans, local healthcare systems' capabilities, and coordinate complex medical cases to ensure high-quality, cost-effective care and patient safety. Your role includes managing medical monitoring, facilitating safe evacuations, and supporting travelers with complex treatment needs, both internationally and within the USA.

Responsibilities

• Manage global assistance cases, collaborating with interdisciplinary teams (logistics, healthcare intelligence, Medical Directors, and Physician Advisors).
• Triage global medical cases, complete clinical assessments, and communicate case directions to logistics specialists for evacuations or continued local care.
• Work collaboratively with international and domestic healthcare providers to ensure high-quality, cost-effective care management, proactive discharge planning, and medically safe travel arrangements.
• Manage complex medical cases, including obtaining and reviewing medical reports/records and communicating directly with treatment facilities and providers.
• Engage in provider and facility quality assurance reviews as needed.
• Document all conversations with providers, medical records reviews, and patient care-related communications for continuity and care management.
• Identify and escalate potentially fraudulent activities during the pre-authorization evaluation process.
• Monitor and support complex, high-cost cases through collaboration with the Emergency Response and Assistance Team, including Medical Directors, Global Care Consultants, and Healthcare Intelligence team members.
• Establish relationships with hospitals, nurses, doctors, and social workers to facilitate information collection and improve patient care.
• Perform other duties or projects as assigned.

Requirements

• Bachelor's degree (BSN) or equivalent experience.
• Active licensure in the United States as a Registered Nurse.
• 3+ years of critical acute care clinical experience, including ER, ICU, critical care, trauma, triage, and/or international travel nursing.
• Proficiency in medical terminology and Electronic Medical Records (EMR).
• Proficiency with Microsoft Word, Excel, and online computer systems for data entry, research, and information gathering.
• Ability to work 8-to-12-hour shifts, including every other weekend and holidays, in a 24/7 environment.

Preferred Qualifications

• Experience in medical assistance, aeromedical, flight nursing, cruise line, air medical transport, or international travel nursing.
• International travel experience with awareness of cultural variations and challenges in global healthcare delivery.
• Familiarity with evidence-based practice guidelines.
• Second language proficiency (e.g., Spanish, French, Portuguese, Arabic, Mandarin).

Skills

• Problem Solving: Identify and resolve problems quickly; gather and analyze information; develop alternative solutions; work well in group problem-solving situations.
• Interpersonal Skills: Focus on conflict resolution; maintain confidentiality; listen without interrupting; manage emotions; remain open to others' ideas; demonstrate strong customer service.
• Teamwork: Work effectively in multidisciplinary team environments and independently.
• Information Synthesis: Synthesize complex or diverse information from multiple sources; use intuition and clinical experience to complement data.
• Communication: Communicate complex information clearly in spoken and written English to clinical and non-clinical audiences; write clearly and informatively.

Schedule

This role requires availability to work 8-to-12-hour shifts, including every other weekend and holidays, in a 24/7 environment.

Pay

The salary for this role ranges from $60,200 to $107,400 annually, based on full-time employment. Pay is determined by factors such as local labor markets, education, work experience, and certifications.

Benefits

• Comprehensive benefits package (eligibility requirements apply).
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution.