Remote Utilization Review Rn Jobs in Snohomish, WA

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As a NICU Registered Nurse Case Manager, you will act in a liaison role with Medicaid member's  families that are currently receiving care or have previously received care in the NICU to ensure appropriate care is accessed as well as to provide home and social assessments and member and family education. RN Case Manager will coordinate care that focuses on supporting members' medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improve quality of care. Interest in learning to work with medically complex patients that are currently receiving care or recently received care in a NICU setting is important for this role. You'll need to be flexible, adaptable and, above all, patient in all types of situations.

If you reside in the state of WA, preferably the Greater Seattle or Tacoma area, you will have the ability to work remotely as you take on some tough challenges.

Primary Responsibilities: 

• Engage members 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
• Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team

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 RN licensure in the state of Washington
• 2 years of NICU clinical experience 
• 1 year of experience with MS Office, including Word, Excel, Outlook, and TEAMs
• Reside in the state of Washington
• Designated, quiet workspace and access to install secure high speed internet via cable/DSL in the home

Preferred Qualifications:  

• CCM certification
• 1 year of Case Management experience coordinating care for individuals with complex needs
• Background in Managed Care
• Experience working in team-based care
• Experience with Maternal Health and/or Pediatric Health
• Bilingual English and Spanish

*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 hourly pay for this role will range from $40.00 to $54.00 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.