RN Case Manager - SNF - Remote in Utah

Skilled Nursing Facility (SNF) Case ManagerOptum UT is seeking a Skilled Nursing Facility (SNF) Case Manager to join our team in Draper, UT. Optum is a clinician-led care organization that is changing the way clinicians work and live.As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us in improving healthcare through the power of people and intelligent technologies while Caring. Connecting. Growing together.The Skilled Nursing Facility (SNF) Case Manager is responsible for coordinating and managing care for Medicare Advantage members admitted to skilled nursing facilities. This role collaborates with facility staff, providers, members, caregivers, and interdisciplinary teams to support safe transitions of care, improve member outcomes, reduce avoidable hospital readmissions, and promote appropriate skilled nursing facility length of stay through proactive care coordination and case management interventions. This position serves as a key liaison between the health plan, facility partners, providers, members, and caregivers to ensure timely, effective, and member-centered care. The SNF Case Manager plays a critical role in mitigating financial and quality risks to the organization.Candidate must live and possess an active and unrestricted Utah RN licenseIf you are located in the state of Utah, you will have the flexibility to work remotely* as you take on some tough challenges.Position Highlights & Primary Responsibilities:Manage a caseload of Medicare Advantage members admitted to skilled nursing facilitiesDevelop, implement, and monitor individualized care plans based on member needs, goals, and available resourcesCollaborate with SNF staff, physicians, advanced practice providers, therapists, caregivers, and interdisciplinary teams to coordinate care and support positive outcomesParticipate in interdisciplinary care conferences and discharge planning meetingsMonitor member progress toward established goals and identify opportunities to improve quality, efficiency, and member experienceFacilitate safe transitions between care settings, including discharge to home, assisted living, community-based services, or other appropriate levels of careCollaborate with Community Health Workers and interdisciplinary team members to address social determinants of health and barriers impacting careComplete documentation accurately and within established timelines and regulatory requirementsMaintain knowledge of Medicare guidelines, post-acute care services, community resources, and care management best practicesComply with all organizational, regulatory, privacy, and compliance requirementsFacilitate timely primary care, specialty care, and post-discharge follow-up appointmentsMaintain accurate, timely, and complete documentation in accordance with organizational, regulatory, and accreditation requirementsAdhere to all applicable policies, procedures, HIPAA regulations, and quality standardsParticipate in performance improvement, care coordination, and population health initiatives designed to improve member outcomes and reduce healthcare utilizationPerform other duties as assignedYou'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:Current, unrestricted Registered Nurse (RN) license in Utah3+ years of clinical nursing experience, preferably in acute care, care management, case management, utilization management, discharge planning, or transitional careExperience working within managed care, Medicare Advantage, value-based care, care management, or population health environmentsDemonstrates case management knowledge and ability to independently assess member needs, develop care plans, prioritize interventions, and manage complex cases with minimal supervisionDemonstrated solid clinical assessment, critical thinking, problem-solving, and decision-making skillsDemonstrated excellent written, verbal, and interpersonal communication skillsProven ability to collaborate effectively with providers, hospitals, skilled nursing facilities, Community Health Workers, and interdisciplinary care teamsDemonstrated proficiency with electronic medical records, case management systems, and Microsoft Office applicationsPreferred Qualifications:Bachelor's degree in nursing (BSN)Case Management Certification (CCM, ACM-RN, or equivalent)Experience supporting transitions of care, readmission prevention, post-acute care management, or emergency department utilization programsDemonstrated knowledge of community resources and social determinants of healthKey Performance Indicators:Completes timely assessments and care plan development for assigned membersMeets outreach and engagement goals for assigned SNF membersFacilitates timely and appropriate discharge planning activitiesSupports reduction of avoidable hospital readmissions and emergency room utilizationMaintains productivity and caseload management standardsCompletes documentation accurately and within established timelinesCollaborate effectively with facility partners and interdisciplinary teamsSupports member satisfaction, quality, and care coordination goalsIdentifies and addresses barriers impacting member outcomes and transitions of careMeets productivity and quality performance standardsContributes to improved member outcomes and care experience*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay 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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.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.