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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Medical and Clinical Operations

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

Disease Management Program Manager - Telecommute in Hawaii

UHG - Honolulu, Hawaii

Posted: 11/12/2018

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

 

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

 

Primary Responsibilities:   

  • Make outbound calls to assess members' current health status
  • Identify gaps or barriers in treatment plans
  • Provide patient education to assist with self - management (individuals or groups)
  • Interact with Medical Directors on challenging cases
  • Coordinate care for members as necessary
  • Make referrals to internal and external sources as needed
  • Coordinate services as needed (home health, DME, etc.)
  • Educate members on disease processes
  • Encourage members to make healthy lifestyle changes
  • Document and track findings
  • Make Welcome Home calls to ensure that discharged members receive the necessary services and resources
  • Work with providers on challenging cases
  • Utilize transtheoretical model to change members’ behaviors
  • Notify providers on members with significant changes in condition(s)
  • Vendor oversight for performance and outcomes
  • Collaborate and work with other disciplines in ensuring program effectiveness
  • Maintain and update disease management P&Ps annually and present to appropriate Committee(s)
  • Complete annual disease management evaluation and program description

Required Qualifications:

  • Current, active and unrestricted RN license in the State of Hawaii
  • 4+ years of clinical experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
  • 2+ years of Case Management/Service Coordination experience
  • 2+ years of Disease Management/Wellness & Prevention experience
  • Experience in member assessments and care plan development
  • Knowledge of community resources, preferably across all islands
  • 2 + years of experience working with MS Word, Excel and Outlook
  • Able to travel to different sites including the neighbor islands (approx.10%)
  • Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area
  • Current access or ability to obtain internet access via a landline 

Preferred Qualifications:

  • BSN 
  • CCP Certification - Chronic Care Professional Certification
  • A background in managed care
  • Certified Case Manager (CCM)
  • Experience/exposure with discharge planning
  • Experience in utilization review, concurrent review and/or risk management
  • Experience delivering counseling or health education and/or working with individuals directly to facilitate behavior change and improve health and well-being

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do 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.

 

 

Keywords: RN, Registered Nurse, Case Manager, Disease Manager, Service Coordinator, Disease Management, Program Manager, Case Management, Managed Care, Medicaid, Medicare, Health Care, Clinical, Telephonic, Telecommute, Honolulu, HI, Hawaii

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