RN Case Manager

Employer
UnitedHealth Group
Location
Columbia, MD
Posted
Oct 19, 2021
Closes
Oct 21, 2021
Ref
152185192
Industry
Insurance
Hours
Full Time
Energize your career with one of Healthcare's fastest growing companies. You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 10 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:00am - 5:30pm. It may be necessary, given the business need, to work occasional overtime. Our office is located at 9204 BERGER ROAD STE A, COLUMBIA, MD 21046 Primary Responsibilities: Review and advise on medications and treatment plans (based on review of medical case notes, medication list and lab results) to improve outcomes and avoid potential drug interactions. Discuss with patients life issues affecting medication adherence and provide advice on improving drug regiment compliance. Advise patients on alternate Rx fill strategies of retail versus mail order and options for financial assistance. May outreach to providers on suspected medication abuse situations. Review medication regimen for disease state for LTC facilities/hospice care/RN case managers/medical directors/clients and provide summaries and guidance on future medication plans. Advice may include alternate drug therapies, stopping a medication and/or lower cost alternative. Review medical case notes to determine on-going medication treatment plan and project future medication costs. Works with team to solve complex problems. 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: High School Diploma / GED (or higher) 1+ years of insurance verification and authorization experience. 1+ years experience with ICD-9 or ICD-10 1+ years of customer service experience Basic knowledge of medical terminology Proficient with Microsoft Word (editing and creating documents), Microsoft Excel (editing and creating spreadsheets) Ability to work Monday through Friday 9:00am to 5:30pm based on business needs and flexibility to work weekend rotation Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance. Preferred Qualifications: PBM experience Pharmacy claims experience Experience with J-Codes, S-Codes or A-Codes UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status. Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do. If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing 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. Keywords: UHG, OptumRx, healthcare, pharmacy, insurance, claims, hiring immediately, #RPO