This position is both field based (approximately 60%) and telephonic / work from home (approximately 40%). The territory for this position will be the greater Nassau/ Long Island New York area. When in the field you will be meeting with beneficiaries primarily in facilities and also may require home visits as needed. You must be available to be in your territory on a daily basis. The schedule is Monday - Friday during normal business hours.
The overall purpose of the Nurse Case Manager is to improve the enrollee's ability to remain stable in the community and out of the hospital. This role will work within our Whole Person Care model, with a particular focus on Behavioral Health needs. The role is to engage the person in the treatment process and then assist them to access the appropriate community services so they can pursue their treatment goals in the community and avoid hospitalization. This position will be making field visits going into member homes, hospitals, clinics and other facilities.
The Nurse Case Manager position is also designed to be a direct clinical liaison between health plan staff and the clinical network. The program fosters a collegial and mutually beneficial relationship between the providers and payers of medical and behavioral health services.
- Identifies needed services and matches with available services in area
- Assists enrollees with appointments
- Provides subsequent member follow-up as determined by individual member needs
- Works with enrollees to identify gaps in care or obstacles to care and problem solves for successful connection to needed services
- Reviews IP Census each day to determine which enrollees on the census are re-admits within the last 12 months
- Collaborate with treatment team to develop a successful aftercare plan
- Manages the aftercare follow-up of identified high risk enrollees (manages follow-up calls/outreach and documentation)
- Communicates with community providers/facilities as company liaison to foster good rapport and relationships and to identify new programs
- Works with CNS to identify new facilities and programs that provide services to targeted populations
- Current, unrestricted RN license in the state of New York
- 2+ years' experience in a related mental health / behavioral health / psychiatric environment as an RN
- Associates degree or greater in nursing
- Proficient computer skills and good working knowledge of Microsoft Word
- Live in a commutable distance of greater Nassau/ Long Island area and be able to be in the territory on a daily basis
- Medical/Behavioral setting experience (i.e. hospital, managed care organization, or joint medical/behavioral outpatient practice)
- Dual diagnosis experience with mental health and substance use disorders
- Experience working with low-income populations
- Experience working with the aged, blind or disabled
- HIV/AIDS case management experience
- Domestic violence experience
- Case Management experience
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.