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Senior Case Manager RN - Oldsmar, FL or Sugarland, TX

Company: UnitedHealth Group
Location: Sugar Land
Posted on: January 6, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing - your life's best work.(sm)
*** $1,000 Sign On Bonus for External Candidates ***
Senior RN Case Managers are RNs who serve as a key member of the UnitedHealthcare Global Emergency Response Center Team and utilize evidenced based practice to assess global traveler's medical care needs, treatment plans of healthcare providers and the ability of the local healthcare systems to provide appropriate quality and cost effective care when acute, chronic or catastrophic events occur in countries around the world. RNs evaluate, recommend and monitor patient status and associated treatment plans to ensure complex medical cases are managed to the highest level of quality and patient safety. RNs coordinate with appropriate providers and assist in establishing and implementing plans including but not limited to a patient's medical monitoring, return home, and safe evacuation to a location where appropriate care is available when it's determined the care needs cannot be met in the current location.
RNs establish a good relationship with the hospital, doctors, social workers gaining their trust and respect to facilitate the collection of information and improve the image of the company and patient care. RNs document all conversations with providers and physicians, medical records review and any patient care related phone call to ensure information is available to all team members for continuity and care management. -The nurse identifies and escalates potentially fraudulent activities identified during the pre-authorization evaluation process. -Complex and high cost cases are uniquely reported, monitored and supported through the collaboration with all members of the Emergency Response Team to include: Medical Directors, GCCs, Healthcare Navigators and Healthcare Intelligence team members to facilitate seamless provision of healthcare services to those we serve.
*** Candidates must be available to work 8 - 10 hour shifts including every other weekend and holidays as dictated by needs of business in a 24/7 environment ***
Primary Responsibilities:
Managing global assistance cases
Collaborating with interdisciplinary team members (eg: logistical and healthcare intelligence) as appropriate on case work
Collaborating with Medical Directors and Physician Advisors when appropriate
Triage global medical cases, complete clinical assessment and communication of case direction to the logistics specialists to facilitate the necessary evacuation or continued monitoring of care being provided locally
Works collaboratively with international and domestic healthcare providers and internal colleagues to assure appropriate high quality cost-effective care management, proactive discharge and medically safe travel planning, optimize patient health
Participates in the management of complex medical cases and collation of clinical information to assess and expedite assessment of care needs. This includes obtaining and reviewing verbal and written medical reports / records as well as communicating directly with the treating facilities and providers
Engages in provider and facility quality assurance review as determined by business need

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:
Holds active licensure in the United States as a Registered Nurse
Bachelor's degree (BSN) or equivalent experience
3+ years of critical acute care clinical experience including but not limited to ER, ICU, critical care, trauma, triage and/or international travel nursing experience
Proficient in medical terminology
Proficient with Microsoft Word and Excel including online computer systems for data entry, research and information gathering
Ability to work 8 - 10 hour shifts including every other weekend and holidays as dictated by needs of business in a 24/7 environment
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:
Experience and/or broad medical knowledge in medical assistance business, experience in aeromedical, flight attendant, military flight nursing, cruise line, air medical transport, and/or international travel nursing
International travel experience with awareness and understanding of the variation in cultures and the challenges of healthcare delivery in the global arena and the potential impact on the health and safety of travelers
Familiarity with evidence-based practice guidelines
Second language proficiency (Spanish, French, Portuguese or other)
Soft Skills:
Problem Solving - Ability to identify and resolve problems quickly, gathers and analyzes information skillfully; develops alternative solutions; works well in group problem solving situations; uses reason when dealing with emotional topics
Interpersonal skills - Focuses on solving conflict, maintains confidentiality; listens to others without interrupting; keeps emotions under control, remains open to others' ideas and tries new things. -Demonstrates strong customer service; includes managing difficult situations
Works well in multidisciplinary team environments and is comfortable working independently
Synthesizes complex or diverse information from multiple information sources. Uses intuition and clinical experience to complement data to create greater understanding of a likely scenario
Excellent Communication Skills, ability to communicate complex information in spoken and written English in a simple clear format to both clinical and non-clinical audiences. Writes clearly and informatively

To protect the health and safety of our workforce, patients, and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state, and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidat es prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of 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.

Job Keywords: Registered Nurse, RN, Nurse, ER, Emergency Room, Trauma, Critical Care, ICU, Manager, Tampa, Safety Harbor, St. Petersburg, Oldsmar, FL, Florida, UHC, UnitedHealthcare

Keywords: UnitedHealth Group, Sugar Land , Senior Case Manager RN - Oldsmar, FL or Sugarland, TX, Healthcare , Sugar Land, Texas

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