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Job Information

UnitedHealth Group Transplant RN Case Manager - Telecommute in Las Vegas, NV - $7K Sign On Bonus for External Candidates in Las Vegas, Nevada

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

As the Transplant RN Case Manager, you will be responsible for the management and coordination of case management services for members having complex needs and requiring complex services in the Transplant Department. You will work directly with the member, providers, facilities and other entities to ensure that the patient is assisted through all phases of the transplant process. The Case Manager will manage members from all lines of business and maximize outpatient management of transplant members by ensuring the member is connected with the appropriate medical and social resources and is educated on managing their disease process. In addition, you will also minimize the time between transplant referral and listing.

If you are located in the Las Vegas, NV area, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Coordination of member's care through the health care continuum

  • Collaborate with member, provider, facility to obtain best outcome

  • Collaborate with internal members of the health care team, to include PCP, FHS, COC and Medical Director

  • Communicate/Develop/Implement ongoing plan of care in conjunction with member and providers

  • Act as resource to SMA and Network providers, contracted transplant facilities

  • Evaluate, measure and report on outcomes

  • Utilize written criteria to approve, pend, and/or send case to medical director for review

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 and unrestricted RN license in the state of Nevada

  • 4+ years case management experience

  • Proficient in Microsoft Word, Excel and Outlook

Preferred Qualifications:

  • Bachelor’s degree

  • CCM

  • Managed care experience

  • Authorization experience

  • Knowledge NCQA, CMS and other regulatory agencies

  • Transplant experience

  • UNOS experience

Soft Skills:

  • Excellent oral and written communication skills

  • Demonstrates initiative toward problem solving skills

  • Demonstrated critical thinking skills and ability to formulate innovative plan of care for complex cases

  • Recognizes others deficits and assists to train/motivate improvement in their skill sets

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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: Transplant RN Case Manager, Registered Nurse, RN, Nurse, CCM, Case Manager, Case Management, Healthcare, Managed Care, MCO, Prior Authorization, Transplant, NCQA, CMS, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

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