Please note the schedule is Thursday through Sunday - 7am - 5pm CST or 8am - 6pm EST
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
If you are located in the state of LA, you will have the flexibility to telecommute* as you take on some tough challenges. Candidate must reside in Louisiana.
- Perform utilization and concurrent review of inpatient cases using InterQual care guidelines
- Conduct clinical chart assessments
- Build and maintain relationships
- Discuss cases with treating physicians and other healthcare professionals to better understand plans-of-care
- Participate in rounds with the Medical Director and discussing cases as needed
- Determine need, if any, for intervention and discussing with Case Managers and physicians
- Identify and evaluate delays in care
- Initiate a discharge planning and readmission prevention plan
- Approve bed days for inpatient cases (when applicable)
- Arrange alternative care services; contact and maintain communication with acute long-term care, acute rehabilitation, or skilled nursing facilities to move patients through the care continuum
- Gather clinical information to assess and expedite care needs
- Facilitate timely and appropriate care and effective discharge planning
- Participate in team meetings, education discussions, and related activities
- Maintain appropriate documentation
- Consult with the Medical Director as needed to troubleshoot difficult or complex cases
- Identify opportunities for improved communication or processes
- Participate in telephonic staff meeting
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.
- Current, unrestricted RN license in Louisiana
- 3+ years total RN experience including recent clinical experience
- Demonstrate a proficiency in computer skills - windows, IM, excel (Microsoft suite), Outlook, clinical platforms
- Workspace in their home that is separated from non-workspace areas and that can be secured to maintain Protected Health Information (PHI) and/or Protected Information (PI)
- Living in a location that can receive high - speed internet service with a minimum speed of 5 download mps & 1 upload mps. Mobile cellular data, e.g., fixed wireless, air cards / MiFi devices, and satellite are not approved means of internet connectivity and do not meet the criteria for high-speed internet connection through an Internet Service Provider
- Bachelor’s degree
- Case management certification and/or experience
- 2+ years of case management experience
- 1+ year of UM / UR experience required including experience performing admission and continued inpatient stay reviews using Interqual criteria
- Experience in acute long-term care, acute rehabilitation, or skilled nursing facilities
- Experience in discharge planning and/or chart review
- Experience with utilization review for an insurance company or in a managed care environment
- Auth experience
- Medicaid and commercial insurance experience
- Familiarity with InterQual care guidelines
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job keywords: Post-Acute Inpatient Care Manager RN, Clinical, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Baton Rouge, LA, Louisiana