Hospital Safe Discharge RN Case Manager - Remote

Hospital Safe Discharge Case ManagerFor 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 in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.The Hospital Safe Discharge Case Manager initiates proactive outreaches to facility CM/UM/Discharge staff upon generating the daily census to manage discharges, working collaboratively with the facility discharging staff to assist in resolving any discharge barriers and continuing to engage facility staff until the actual discharge.The schedule for this position is based on Eastern Standard Time Zones; required shifts are 8AM-5PM EST; subject to change depending on business needs.You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:Assessing barriers to a safe and efficient discharge process, identifying the relevant resources, and finally coordinating and driving an efficient discharge process with both internal and external stakeholdersDemonstrates exemplary knowledge of acute inpatient case management, utilization management and care coordination processes as a foundation for transition planning activitiesManages assigned case load in an efficient and effective manner utilizing time management skillsPrepare and lead periodic rounds to discuss case needs, prioritize patients/discharges/issues/facilities and facilitate the member's transitions of careProficient in utilizing multiple electronic platforms, applications, and Electronic Medical Record (EMR) systems to coordinate patient care, document clinical information, and ensure accurate and timely communication among interdisciplinary teamsConfers with Medical Director or other leadership as appropriate for review of complex case situationsWorking knowledge of skilled criteria for other levels of care; Skilled Nursing Facility, Acute Rehabilitation, and Home HealthIdentifies and communicates a member's level of risk and participates in planning to mitigate those risksWorking closely with hospital staff, patients, families, and community services to promote a safe discharge plan and quality careCommunicates and supports hospital staff in facilitating member transition to other levels of post-acute careCultivate and build relationships, especially where one does not exist or is challenging, with hospitals and their personnel to build a collaborative discharge management relationshipContinuously look for opportunities to improve and streamline the discharge process, communicating with leadership innovative ideas and opportunities to optimize processes and outcomesCollaborate closely with internal and external partners to aggressively drive safe discharges to achieve higher daily discharge volume and overall lower LOSUse existing tools and communication platforms to support member transitions of care post dischargeEnters timely and accurate documentation into designated care management applications to comply with documentation requirements and achieve audit scores of 90% or better monthlyAdheres to organizational and departmental policies and proceduresTakes on-call assignment as directedDecision-making is based on regulatory requirements, policy and procedures and current clinical guidelinesMaintains current knowledge of health plan benefits and provider network including inclusions and exclusions in contract termsRefers cases for additional support/management as deemed appropriate, following all mandated reporting laws and ethical boundsMonitors for any quality concerns regarding member care and reports as per policy and procedurePerforms all other related duties as assignedRequired Qualifications:Bachelor of Science in NursingCurrent, unrestricted RN license - Compact State License5+ years of nursing experience in an acute care setting2+ years of discharge planning experienceKnowledge of utilization management and quality improvementComputer proficiency in Microsoft Office applications including Outlook, Word, and ExcelDemonstrated ability to read, analyze and interpret information in medical records, and health plan documentsProven ability to utilize critical thinking skills, nursing judgement, and decision-making skillsProven ability to prioritize, plan, and handle multiple tasks/demands simultaneouslyPreferred Qualifications:Case Management certification1+ years of recent inpatient clinical documentation integrity (CDI) experienceExperience working with psychiatric and geriatric patient populationsExperience with managed care and/or case management experienceExperience managing patients with SUD and/or Behavioral Health conditionsKnowledge of CMS coding guidelines and DRG assignmentInterQual/MCG Guidelines or other nationally recognized practice guidelinesPhysical & Mental Requirements:Ability to sit for extended periods of timeAbility to stand for extended periods of timeAbility to use fine motor skills to operate office equipment and/or machineryAbility to receive and comprehend instructions verbally and/or in writingAbility to use logical reasoning for simple and complex problem solvingAll employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $29 - $52 per hour based on full-time employment. We comply with all minimum wage laws as applicable.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.