MS, or US National Candidates need to be able to work in the City or State specified – Telecommute
Title: RN – Discharge Care Manager Mississippi
Location: Jackson Mississippi United States
Division: Post Acute Care Mgmt
Contest Number: 817941
Function: Clinical Utilization Managemen
Business Segment: UHC Clinical Services
Region: North America
Country: United States
JobLevel: Individual Contributor
Shift: Day Job
Overtime Status: Exempt
Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Utilization Management Nurse at UnitedHealth Group, you will make sure our health services are administered efficiently and effectively. You’ll assess and interpret member needs and identify solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready to make an impact?
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
The DCM will coordinate and document the discharge plan in collaboration with other key clinical care team members. The DCM will follow the member while in the acute inpatient setting and responsibilities will include but are not limited to:
Evaluation of member discharge needs including delays in care and readmission prevention plan.
Collaboration with providers and members to coordinate care post discharge
Participate in rounds with the Medical Director to discuss cases as needed
Identification of internal or community based program support or resources
Coordination with the facility Discharge Planner to ensure post hospital services are arranged prior to the member being discharged.
Assist with coordination of difficult cases needing placement in an alternate level of care facility.
Referral to Social Worker for assistance when needed
Documentation of discharge activities as outlined in standard operating procedures and data entry strategies.
Participate in team meetings, education discussions and related activities.
Works collaboratively with team members in a matrix environment to ensure an end to end positive experience for members, providers and care teams.
A current, unrestricted RN license in Mississippi is required
3 or more years total RN experience post licensure
Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance and achieve targets
Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
Ability to build and maintain relationships will be essential
Proficiency in typing skills and software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint and Microsoft Outlook
Experience working with multiple health insurance products (i.e. Medicaid, Medicare, Commercial) within the insurance industry, including regulatory and compliance requirements
Mississippi residency required (Relocation assistance is not available for this position)
3 years’ experience of discharge planning; case management and/or utilization management
MCG Guidelines or other nationally recognized practice guidelines preferred
A Bachelor’s of Science in Nursing is preferred
A case management certification is preferred
Bilingual a plus
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Medical & Health , Case Management , Nursing