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Medical Case Manager

UnitedHealth Group

This is a Full-time position in Stuart, FL posted May 3, 2021.

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)

The Healthcare Manager is responsible for successfully supporting patients with high risk health conditions to navigate the healthcare system. The Healthcare Manager assists in developing patient empowerment by acting as an educator, resource, and advocate for patients and their families to ensure a maximum quality of life. The Healthcare Manager interacts and collaborates with multidisciplinary care teams, to include physicians, nurses, pharmacists, laboratory technologists, social workers, and other educators. The Healthcare Manager acts as a resource for clinic staff. The Healthcare Manager works in a less structured, self-directed environment and performs all nursing duties within the scope of a RN license of the applicable state board of nursing.
 
*This clinic is located at 2155 SE Federal Hwy, Stuart, FL 34994 and is open Monday – Friday from 8AM – 5PM*
 
Primary Responsibilities:

  • Works with the providers and clinic staff to identify patients
  • Supports longitudinal care of the patient with chronic care conditions by performing assessment of health conditions, performing medication reconciliation, conducting Motivational Interviewing and Self-Management Goal setting, providing patient education, creating referrals to appropriate agencies and resources
  • Supports transition of the patient with chronic care conditions from inpatient to outpatient setting, by performing assessment of transitional needs, performing medication reconciliation, establishing and reviewing contingency plan, providing patient education, assisting with post discharge needs such as prescriptions, transportation, Durable Medical Equipment (DME), appointments
  • Coordinate with providers to establish or update plan of care
  • Performs accurate and timely documentation in the electronic medical record
  • Participates in daily huddles and Patient Care Coordination (PCC) meetings
  • Prepares accurate and timely reports, as required, for weekly meetings
  • Maintains continued competence in nursing practice and knowledge of current evidence based practices

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:

  • United States Citizenship
  • Ability to obtain favorable adjudication following submission of Department of Defense eQuip Form SF86
  • Bachelor’s degree in Nursing or Associate’s degree in Nursing with 4+ years of experience
  • Registered Nurse with an active and unrestricted license to practice in Florida
  • Current BLS certification
  • 2+ years of experience in a physician’s office, clinical or hospital setting
  • Knowledge of chronic diseases, especially COPD / asthma, diabetes, CHF and IHD
  • Ability to interact productively with individuals and with multidisciplinary teams
  • Strong interpersonal skills
  • Excellent verbal and written skills
  • Proficient computer skills to work efficiently with electronic medical records
  • Excellent organizational and prioritization skills
  • This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor’s diagnosis of disease
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

  • Experience related to patient education and / or motivational interviewing skills and self-management goal setting
  • Fluent written and verbal skills in English and Spanish

Physical & Mental Requirements:  

  • Ability to lift up to 35 lbs
  • Ability to push or pull heavy objects using up to 35 lbs of force
  • Ability to sit for extended periods of time
  • Ability to stand for extended periods of time
  • Ability to use fine motor skills to operate office equipment and / or machinery
  • Ability to receive and comprehend instructions verbally and / or in writing
  • Ability to use logical reasoning for simple and complex problem solving
     

As a requirement of UnitedHealth Group’s contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense eQuip Form SF86, (the National Agency Check Legal and Credit or NACLC). Successful completion of the NACLC process is a requirement for continued employment in this role. NACLC processing will be initiated by our TRICARE Security Officer post-offer and can take 3-6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NACLC approval will result in termination from this role.

If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.

Careers with WellMed. Our focus is simple. We’re innovators in preventative health care, striving to change the face of health care for seniors. We’re impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We’ve joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life’s best work.(sm)

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

Job Keywords: Healthcare Manager, Case Manager Registered Nurse, RN, Registered Nurse, High Risk Patients, Stuart, FL, Florida