Inpatient RN Case Manager - Las Vegas, NV - $1500 Sign On Bonus

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

What makes your clinical career greater with UnitedHealth Group? You'll work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. Here, we're working to help others live healthier lives while providing an opportunity for you to do your life's best work.(sm)

**Candidates must be flexible to work onsite at a hospital in the Las Vegas and Henderson area.**

Primary Responsibilities:
  • Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care
  • Utilize both company and community-based resources to establish a safe and effective case management plan for hospitalized members
  • Collaborate with patient, family, and health care providers to develop an individualized plan of care that encompasses both acute care episode and post hospital discharge plan
  • Communicate with all stakeholders the required health related information to ensure quality coordinated care and services are provided expeditiously to all hospitalized members
  • Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team
  • Utilize approved clinical criteria to assess and determine appropriate level of care for hospitalized members
  • Understand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health plan
  • Accountable to understand role and how it affects utilization management benchmarks and quality outcomes
  • Provides health education and coaches consumers on treatment alternatives to assist them in best decision making
  • Supports consumers in selection of best physician and facility to maximize access, quality, and to manage heath care cost
  • Coordinates services and referrals to health programs
  • Prepares individuals for physician visits
  • Assesses and triages immediate health concerns
  • Manages utilization through education
  • Identifies problems or gaps in care offering opportunity for intervention
  • Assists members in sorting through their benefits and making choices
  • Takes in-bound calls and places out-bound calls as dictated by consumer and business needs
  • Special projects, initiatives, and other job duties as assigned
  • Work completed in Sub - Acute facilities or Acute Hospital settings
  • Occasional driving up to one (1) hour daily for regular employees per diem employees will drive less than one hour daily and are not subject to the driving requirements
  • Performs the following case management skills on a daily basis:
  • Perform patient assessment of all major domains using evidence-based criteria (physical, functional, financial and psychosocial)
  • Develop individualized discharge plans that involve provider, patient, and caregiver goals for successful transitions of care
  • Implement discharge plan involving health care resources across the continuum
  • Monitor and report variances that may challenge timely quality care


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:
  • Registered Nurse with active unrestricted license in the State of Nevada
  • 3+ years of acute hospital experience in one or more of the following areas: ER, ICU, or IMC
  • Basic to intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word
  • You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role
  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained


Preferred Qualifications:
  • Bachelor's degree
  • CCM certification or ability to obtain within 2 years of employment
  • Case management/utilization review experience
  • Knowledge of Interqual or MCG
  • Experience in a managed care organization


Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

**PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.

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: RN, Nurse, Case Manager, ER, IMC, Med-surg, ICU, Claims, MCG, Milliman, Appeals, Grievances, CCM, Medicaid , Public Health, Care Coordination, Case Management, Utilization Review, Prior Authorization, Discharge Planning, Medical Adjudication, Managed Care, Las Vegas, NV, Nevada

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