Case Manager RN - Remote Eligible

Care Manager, RN

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Optum offers a wide range of career opportunities across clinical and non-clinical roles. As a partner of a statewide healthcare system in Maine, we are committed to delivering personalized, streamlined care to our communities. Whether you're drawn to a large medical center, a rural practice, or home care, you'll find your place with us. Our culture is rooted in compassion, meaningful benefits, and a shared mission of caring, connecting, and growing together. The Care Manager, RN plays a key role in coordinating patient-centered care, ensuring safe discharges, and optimizing transitions through collaboration with patients, caregivers, and the healthcare team. This position supports flexible telecommuting from anywhere in the U.S. while tackling impactful healthcare challenges.

The Care Manager, RN provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team. Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Collaborates and Communicates Effectively: Engages directly with staff, physicians, patients, and families to coordinate care, resolve issues, and ensure clear, respectful communication across all levels
• Leads by Example: Demonstrates leadership through professionalism, courtesy, and efficiency while functioning independently and managing time for maximum productivity
• Coordinates Quality Patient Care: Oversees care processes to achieve optimal outcomes, ensures appropriate resource use, and facilitates patient and family education to support continuity of care
• Manages Utilization and Compliance: Applies knowledge of federal/state regulations, Medicare, and managed care plans to support appropriate length of stay and reimbursement; escalates unresolved cases as needed
• Plans and Facilitates Continuum of Care: Develops and implements discharge plans for complex cases, collaborates with interdisciplinary teams, and ensures timely transitions to the next level of care
• Supports Risk Management and Flexibility: Identifies and addresses potential risk issues, participates in quality improvement initiatives, and remains adaptable to meet hospital needs across all patient age groups

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:

• Associate's degree (or higher) in Nursing
• Current, unrestricted RN license in the state of residence
• 3+ years of experience in a hospital, acute care, or direct care setting
• Intermediate level of proficiency to type and navigate a Windows based environment

Preferred Qualifications:

• Certified Case Manager (CCM)
• Background in managed care
• Case management experience
• Experience or exposure to discharge planning
• Experience in utilization review and concurrent review
• Knowledge/understanding of community resources, policies, and procedures
• Knowledge of Utilization Review, Medicare Requirements processes as well as State and Federal regulations pertaining to Utilization Review and Discharge Planning

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). The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. 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.