RN Case Manager – Remote Work from Anywhere in USA

About the Company

UnitedHealth Group is a diversified health and well-being company dedicated to helping people live healthier lives and helping make the health system work better for everyone. We serve millions of people worldwide with a broad spectrum of products and services through two distinct platforms: Optum and UnitedHealthcare. Our mission is to improve the health and well-being of others, and we continually seek innovative ways to make healthcare more accessible and effective.

Job Description

We are seeking a dedicated and experienced Registered Nurse (RN) Case Manager to join our growing remote team. This is a fully remote position, allowing you to work from anywhere within the United States. As an RN Case Manager, you will be responsible for coordinating the care of members, ensuring they receive appropriate, high-quality, and cost-effective healthcare services. You will collaborate with members, their families, and healthcare providers to develop and implement comprehensive care plans, monitor progress, and advocate for member needs. Your expertise will be crucial in guiding members through complex health journeys, improving health outcomes, and enhancing overall patient satisfaction. This role requires strong clinical judgment, excellent communication skills, and a passion for patient advocacy in a remote work environment.

Key Responsibilities

• Conduct comprehensive assessments of members' health status, needs, and preferences.
• Develop, implement, and evaluate individualized care plans in collaboration with members, families, and healthcare teams.
• Coordinate and monitor the delivery of healthcare services, including medical, behavioral, and social support.
• Educate members on their health conditions, treatment options, and self-management techniques.
• Advocate for members' rights and needs, ensuring access to necessary resources and services.
• Facilitate communication and collaboration among all parties involved in a member's care.
• Identify and address barriers to care, working to resolve issues promptly and effectively.
• Maintain accurate and timely documentation of all case management activities in compliance with organizational standards and regulatory requirements.
• Participate in interdisciplinary team meetings and continuous quality improvement initiatives.
• Adhere to all HIPAA regulations and maintain strict confidentiality of member information.

Required Skills

• Current and unrestricted Registered Nurse (RN) license in a US state (multi-state licensure preferred or willingness to obtain).
• Minimum of 3 years of clinical experience as a Registered Nurse.
• Minimum of 2 years of experience in case management, care coordination, or utilization review.
• Proficiency in using electronic health records (EHR) and case management software.
• Excellent verbal and written communication skills.
• Strong critical thinking, problem-solving, and organizational abilities.
• Ability to work independently and manage a caseload effectively in a remote setting.
• Demonstrated ability to build rapport and establish trusting relationships with members and providers.
• High-speed internet access and a dedicated home office workspace.

Preferred Qualifications

• Bachelor of Science in Nursing (BSN).
• Certified Case Manager (CCM) certification.
• Experience in managed care, home health, or discharge planning.
• Familiarity with HEDIS, 스타즈 (STARS), and other quality improvement initiatives.
• Bilingual skills (e.g., Spanish).

Perks & Benefits

• Competitive salary and performance-based bonuses.
• Comprehensive health, dental, and vision insurance plans.
• 401(k) retirement plan with company match.
• Generous paid time off (PTO) and paid holidays.
• Life insurance and disability benefits.
• Tuition reimbursement and professional development opportunities.
• Employee assistance program (EAP).
• Flexible remote work schedule.
• Access to a robust wellness program.

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