There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)
The Manager of Case Management will supervise and monitor the case management process, act as a liaison for the providers, injured workers, employees, clients and internal staff. Provide direct support and education to staff in the areas of health services for emergency, elective, and appropriate levels of care for medical necessity. Be Responsible for establishing, managing and monitoring utilization standards. Develop policies and procedures as the department or client needs changes. Requires occasional travel. Assume responsibilities as assigned by the Director.
Supervise the daily activities of the RN Case Managers and the Clinical Administrative Supervisor
Provides guidance and assistance to the staff while promoting departmental goals
Monitors the activity of the assigned case management units to assure compliance with policies, procedures and WC Laws and regulations specific to the State where the account is doing business
Monitors quality of care and case management activities through the use of audits and evaluations
Attends client specific required meetings
Make sure as policies and procedures change that client compliance and reference books are updated
If UR Labor Codes or Regulations in CA change, update UR plans and letters as necessary. This would also be the same for any NV accounts if Nevada Statues or Administrative Regulations would change
Provides assistance in handling problems with injured workers, clients, employers, internal and external customers as needed
Acts as liaison for providers, injured workers, and employers’, external and internal staff
- Registered Nurse with active unrestricted license in the State of Nevada and ability to obtain CA license within 6 months of employment
- 3+ years of acute care experience
- 5+ years of managerial/supervisory experience with direct reports
- 5+ years of case management experience
- Previous workers compensation experience
- Basic to intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word
- Experience collaborating with cross-functional teams
- Ability to travel 10% to Carson City for client visits
Active and unrestricted CA state RN license
Certified in Case Management (CCM)
Certified Occupational Health Nurse (COHN)
Multi-state workers compensation experience
If hired, you will need to provide your licensing certification within your first week of employment so that UHC / your manager can apply for your appointment as our agent. If you are not yet licensed, you must pass the state requirements and provide UHC / your manager with the requisite information no later than 30 days after your first day of employment. Failure to provide this required information within the time frames noted or loss of licensure during your employment may result in the termination of your employment.
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)
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: Registered Nurse, Nurse, RN, Clinical, License, Utilization Review, Utilization Management, Prior Authorizations, Case Manager, Case Management, Care Coordinator, Claims Adjudication, Occupational Health, Case Manager, Workers Compensation, CCM, OSHA, ADA, Manager, Supervisor, Las Vegas, NV, Nevada, UHC, UnitedHealthcare