RN Supervisor, Case Management

Job Title

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.

Primary Responsibilities

• Functions as a hands-on supervisor, coordinating and monitoring clinical and non-clinical team activities to facilitate integrated, proactive case management, ensuring compliance with regulatory and accrediting standards
• Oversees an integrated team responsible for complex case management, disease management, care coordination, and population health management
• Manages and evaluates teammates including remote-based teammates in the performance of various CM activities; provides coaching, counseling, employee development, and recognition; and assists with selection, orientation and mentoring of new team members
• Ensures that teammates complete quality audit reviews
• Performs and promotes interdepartmental integration and collaboration to facilitate the continuity of care including transitions of care
• Maintains adequate staffing, service levels and customer satisfaction by implementing and monitoring teammate productivity and other performance indicators
• Reports on CM statistics including teammate productivity, cost effective utilization of services, management of targeted member population, referrals to case management and triage activities
• Evaluates services provided and outcomes achieved and recommends enhancements/improvements for programs and team development to ensure consistent cost effectiveness and compliance with all state and federal regulations and guidelines including HIPAA
• Maintains professional relationships with provider community and internal and external customers while identifying opportunities for improvement
• Communicates with management regarding development within areas of assigned responsibilities and works on special projects as required
• Identifies and addresses opportunities for quality improvement in all aspects of serving our customers
• Assists in planning and implementation of systems changes and procedures to achieve overall organizational objectives
• Other duties as assigned

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.

Required Qualifications

• Associates Degree in Nursing
• Valid NM RN License
• 3+ years of experience providing case management functions within health plan OR integrated system with one 1+ years of supervisory experience
• Travel between offices and facilities for training and meetings
• Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications

• Bachelor's Degree in Nursing
• Knowledge of HMO's, PPO's, Medicare, Medicaid, and insurance plans
• Knowledge of CPT4/ICD 9 & 10/HCPCS codes
• Ability to communicate and interact professionally with co-workers, management patients, and providers
• Ability to counsel and/or consult
• PC proficient

Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.