Outpatient RN Case Manager - Las Vegas, NV - $1500 Sign On Bonus for External Candidates

Careers at UnitedHealth Group

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The Outpatient RN Case Manager will be responsible for the management and coordination of Case Management services for members with complex needs and requiring complex service. The Outpatient Case Manager works directly with the member, provider(s), facilities and other entities to ensure the most appropriate care is provided. The Case Manager manages members from all contracted product lines.

The Case Manager assesses, plans, implements, coordinates, monitors, creates an individualized care plan that meets NCQA guidelines and evaluates the outcomes, ensuring options and services required to meet the member's health needs are best utilized. The Case Manager provides advocacy, communication and resource management and promotes quality and cost-effective interventions and outcomes.

** Candidates must be available to work Monday - Friday 8:00 am - 5:00 pm **

Primary Responsibilities:
  • Coordination of member's care through the health care continuum
  • Collaborate with member, provider, facility and health plan care team (to include PCP, COC, Medical Directors and Community Services) to develop and implement and ongoing plan of care to obtain best outcome
  • Act as resource to SMA and Network providers
  • Provide health education, coaching and treatment decision support for members
  • Ensure NCQA survey ready at all times for all lines of business

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:
  • Current, unrestricted license RN license in the State of Nevada
  • 2+ years of clinical experience in a hospital setting; direct patient care experience
  • Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word and Excel
  • Ability to obtain nursing licenses in CA, UT, LA and AZ within 6 months of employment
  • You will be asked to perform this role in an office setting or other company location, however, may be required to work from home temporarily due to space limitations
  • 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
  • RN licensure in CA, UT, LA and/or AZ
  • Certification in Case Management (CCM)
  • 1+ years of case management experience
  • Experience with NCQA, CMS and other regulatory agencies
  • Managed care experience
  • Knowledge of high-risk adult disease state management
  • Knowledge of high-risk pregnancy disease state management
  • Knowledge of high-risk pediatrics disease state management


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 a 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 drugfree workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Outpatient RN Case Manager, Registered Nurse, RN, Nurse, Case Manager, Adult CCM, High Risk, Pediatric, OB, Obstetrics, CCM, Medicaid , Public Health, Care Coordination, Case Management, Disease Management, NCQA, CMS, Utilization Review, Prior Authorization, Discharge Planning, Managed Care, Las Vegas, NV, Nevada, UHG, UnitedHealth Group, UHC, UnitedHealthcare

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