RN Case Manager

Unitedhealth Group Inc. Downey , CA 90240

Posted 7 months ago

AppleCare Medical Management Group was incorporated in 2003. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors - but the mission has remained the same. Today, AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities.

As a part of our continued growth, we are searching for a new Complex Case Manager to join our team!

Primary Responsibilities:

  • Provides health education and coaches consumers on treatment alternatives to assist them in best decision making

  • Supports consumers in selection of best physician and facility to maximize access, quality, and to manage heath care cost

  • Coordinates services and referrals to health programs

  • Prepares individuals for physician visits

  • Assesses and triages immediate health concerns

  • Manages utilization through education

  • Identifies problems or gaps in care offering opportunity for intervention

  • Takes in - bound calls and places out - bound calls as dictated by consumer and business needs

  • Assists members in sorting through their benefits and making choices

Required Qualifications:

  • Current, unrestricted RN California licensure

  • 3 years of Clinical RN experience

  • 2 years of case management experience in a managed care, hospital or clinic setting.

  • Intermediate computer skills (Microsoft Word, Outlook and Internet) with the ability to navigate a Windows environment and the ability to create, edit, save and send documents utilizing Microsoft Word

Preferred Qualifications:

  • Bachelor's degree in Nursing

  • Coaching and / or decision support experience

  • Managed care experience

  • Strong inbound and outbound telephonic skills

  • Understanding of change and ability to move members along the continuum of change

  • Intermediate or expert level of proficiency with being able to assess and identify needs and being able to influence and motivate

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

AppleCare Medical Management Group was incorporated in 2003. Over the last 17 years, the multispecialty medical group of independent practices has expanded into new communities, contracted with more hospitals and health plans, and added over 50 new doctors - but the mission has remained the same. Today,AppleCare Medical Management is comprised of hundreds of board-certified private-practice, independent physicians. Collectively, our physicians have been serving the Southeast area of Los Angeles and Northern Orange County for decades, providing their medical expertise and passion to improving the health of our communities.

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: RN, LVN, Complex Care, Case Manager, CCM, High Risk, managed care, Seniors, hospital, clinic, Downey, Bellflower, CA, California


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