NICU Case Manager - Remote

$5,000 Sign On Bonus for External Candidates

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

Are you ready for your next challenge? Discover it here at UnitedHealth Group and help us reinvent the health system. We're going beyond basic care, providing integrated health programs with a member-centric focus. The challenge is ensuring we deliver the right care at the right time. When you join us as an NICU RN Case Manager, you'll be making a difference in peoples' lives and will be responsible for discharge planning, improved transitions of care, and utilization management of hospitalized health plan members. You will ensure patients receive quality medical care in the most appropriate setting.

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

If you are reside within Las Vegas, NV area, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities

• Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least 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

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
• 2+ years of NICU clinical experience
• Exceptional knowledge in NICU and assessment
• Intermediate level of proficiency using a PC in a Windows environment, including MS Word and Excel

Preferred Qualifications

• CCM certification or ability to obtain within 2 years of employment
• Case management/utilization review experience
• Experience in a managed care organization
• Knowledge of Interqual or MCG  

*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 $28.94 to $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.