What are the responsibilities and job description for the RN Care Coordinator/Case Manager ED position at UnitedHealth Group?
About UnitedHealth Group
We are creating something new in health care, uniting industry-leading solutions to build an integrated care model that addresses an individual's physical, mental and social needs.
Our Mission
To work with extraordinarily talented people who are committed to making a positive impact on society by transforming health care.
Job Description: RN Case Manager
The RN Case Manager monitors real-time 'Admit, Discharge, Transfer' (ADT) notifications to provide proactive patient and provider outreach and discharge coordination. They support ED discharge follow-up care using approved clinical guidelines to transition patients to an appropriate next site of care in collaboration with the hospitals/physician team and available outpatient ecosystem resources.
Responsibilities:
- Collaborate with ED and outpatient care teams to establish an individualized transition plan for members
- Serve as the clinical liaison with hospital, clinical and administrative staff to perform transition of care/care coordination for ED discharges
- Perform expedited, standard, concurrent, and retrospective clinical reviews at in network and/or out of network facilities
- Interact with ED staff, members, and their families/designated representative to assess discharge needs, formulate discharge plan, and provide health plan benefit information
- Identify member's ED discharge support opportunities level of risk by monitoring real-time ADT feeds and communicate with patient, ED, and outpatient teams for discharge coordination
- Conduct transition of care outreach following ED discharge to confirm access and completion of discharge plan
Requirements:
- Current, unrestricted Multistate RN license
- 4 years of diverse clinical experience in caring for acutely ill patients with multiple disease conditions
- Knowledge of utilization management, quality improvement, and discharge planning
About Us
We are part of the UnitedHealth Group family of businesses and believe everyone deserves the opportunity to live their healthiest life. We offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution.
