Remote Director Case Management Jobs in Riverside, NJ

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

As a Discharge Care Manager at UnitedHealth Group, you will be responsible for implementing day-to-day telephonic case management interventions for identified high risk members. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization.

The Discharge Care Manager (DCM) will coordinate and document the discharge plan in collaboration with other key clinical care team members. The DCM will also follow the member while in the acute inpatient setting.

If you are located in the state of Pennsylvania, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Evaluation of member discharge needs including delays in care and readmission prevention plan
• Collaboration with providers and members to coordinate care post discharge
• Participate in rounds with the Medical Director to discuss cases as needed
• Identification of internal or community-based program support or resources
• Coordination with the facility Discharge Planner to ensure post hospital services are arranged prior to the member being discharged
• Assist with coordination of difficult cases needing placement in an alternate level of care facility
• Documentation of discharge activities as outlined in standard operating procedures and data entry strategies
• Participate in team meetings, education discussions and related activities
• Works collaboratively with team members in a matrix environment to ensure an end-to-end positive experience for members, providers and care teams

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:

• Bachelor of Science in Nursing
• Current, unrestricted Compact RN license in the state of Pennsylvania
• 5 years of recent experience in the acute inpatient hospital setting
• 2 years of experience of discharge planning and/or case management
• Experience working with multiple health insurance products (Medicaid, Medicare, Commercial) within the insurance industry, including regulatory and compliance requirements
• Proficient in typing skills and software applications that includes, but is not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint and Microsoft Outlook
• Designated work space and access to install secure high speed internet via cable/DSL in your home
• Permanent residence within the state of Pennsylvania

Preferred Qualifications:

• Case Management Certification
• InterQual/MCG Guidelines or other nationally recognized practice guidelines
• Experience working as a nurse in the state of Florida
• Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance, and achieve targets

*All 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). 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 $60,200 to $107,400 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 make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is 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 is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.