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UnitedHealth Group RN Case Manager, ProHealth Physicians in Farmington, Connecticut

Opportunities with ProHealth Physicians, part of the Optum family of businesses. When you work at ProHealth Physicians, your contributions directly sustain the health and well-being of our community. Discover high levels of teamwork, robust medical resources and a deep commitment to exceptional care and service. Join a leading community-based medical group and discover the meaning behind Caring. Connecting. Growing together.

Are you ready to make a positive impact in health care? If so, you're the missing piece in our care team. As part of the Optum and UnitedHealth Group family, ProHealth Physicians offers new opportunities for growth. Here, you'll experience:

  • Exceptional teamwork

  • Robust medical resources

  • Passionate professionals with a focus on patient-centered care

ProHealth Physicians is Connecticut's leading community-based medical group. Formed in 1997, we have primary care offices in every county. Our 300+ doctors and advance practice clinicians care for children and adults of all ages. We also have in-house imaging and clinical lab services.

Traditional medicine treats people when they're sick. Instead, we focus on preventing diseases. Our goal is to give our patients - and their communities - the tools they need to be and stay well. This is how we help people live healthier lives.

Our Case Managers (CM) are RNs who are responsible for the coordination of care for high-risk patients (chronic/complex conditions) in the community setting to help keep them out of the hospital while remaining in a safe home environment with quality of life. The CM acts as a longitudinal advocate who links the patient and care givers with the network of care team members to help them gain knowledge of their disease process and to identify community resources for continued growth toward the maximum level of independence.

Position Details:

  • Location : Farmington, CT

  • Department : Care Coordination

  • Schedule : Full-time, 40 hours weekly. Monday through Friday, hours between 8:00AM - 5:00PM. This is a hybrid position.

Primary Responsibilities:

  • Stratifies and /or validates patient level of risk and manages patients across the continuum of care inclusive of care coordination, case management and complex case management

  • Collaborates effectively with physicians, patients/caregivers and families to formulate a patient centric plan of care that meets the medical, psychosocial and financial goals of the patient inclusive of both short- and long-term goals

  • Develops and continuously updates patient centric care plan inclusive of problem, goal, barrier and intervention, enters timely and accurate data into designated care management applications as needed to communicate patient needs

  • Explores care options to reduce cost, decrease length of stay, curtail re-admission and influence quality outcomes

  • Works collaboratively with the Utilization Management/Case Management RNs at the Health Plans, and other Care Team members to facilitate smooth care transitions as well as continuous case management activities

  • Consults with Medical Directors and/or other appropriate programs/resources to overcome barriers to meeting goals and objectives and presents cases to appropriate resources to obtain multidisciplinary view in order to achieve optimal outcomes

  • Maintain a comprehensive working knowledge of community resources, payer requirements and network services for target population to maximize benefit to patient overall well-being

  • Attends and participates in interdisciplinary team meetings as directed

  • Other duties as assigned

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:

  • Undergraduate degree

  • Graduate from an accredited program for professional nursing education

  • Current, unrestricted RN License in the State of Connecticut

  • Active unrestricted RN

  • 3+ years in acute, primary or hospital setting

  • 2+ years of Nurse Case Management experience(hospital, health insurance, care management organization, provider group setting)

  • Experience with Electronic Health Records

  • Reliable transportation

Preferred Qualifications:

  • Bachelor of Science in Nursing

  • Certified Case Manager (CCM)

  • 3+ years of Nurse Case Management experience

  • Experience with Epic

Connecticut Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.

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