Remote Utilization Review Rn Jobs in Methuen, MA

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Wednesday, October 7th | 12pm - 2pm EDT

Register here:  UHC Community & State Massachusetts Virtual Job Fair

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

The RN Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting members' medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care.

If you reside within Essex County, MA and surrounding areas, you will have the flexibility to work remotely* as you take on some tough challenges.

This position is a field-based position with a home-based office. You will work from home when not in the field. Local travel up to 75% and mileage is reimbursed at current government rate.

Primary Responsibilities:

• Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs
• Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines
• Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan
• Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health
• Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission
• Advocate for members and families as needed to ensure the members' needs and choices are fully represented and supported by the health care team

What are the reasons to consider working for UnitedHealth Group?  Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma/GED 
• Current and unrestricted independent licensure as a Registered Nurse for MA
• 2+ years of clinical experience
• Intermediate level of proficiency with MS Office, including Word, Excel and Outlook
• Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
• Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service 
• Access to reliable transportation and valid US driver's license with the ability to travel within assigned territory to meet with members and providers

Preferred Qualifications:

• Bachelor's or Master's Degree in Nursing
• Certified Care Manager (CCM)
• 1+ years of community case management experience coordinating care for individuals with complex needs
• Background in Managed Care
• Experience working in team-based care
• Ability to utilize an Electronic Medical Record or other electronic platforms
• Ability to use on-line training platforms
• Demonstrated ability to utilize virtual care platforms

Physical Requirements:

• Ability to transition from office to field locations multiple times per day
• Ability to navigate multiple locations/terrains to visit employees, members and/or providers
• Ability to transport equipment to and from field locations is needed for visits (e.g. laptop, stethoscope, etc.)
• Ability to remain stationary for long periods of time to complete computer or tablet work duties

*All Telecommuters 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 hourly pay for this role will range from $29 - $52 per hour 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.

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