Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

The Case Manager (CM) is responsible and accountable for coordination of patient services through an interdisciplinary process, which provides a clinical and psychosocial approach through the continuum of care.  Through concurrent case management, patients will be assessed to determine appropriateness of admission, continued hospitalization, as well as appropriate level of care. Case Managers facilitate timely care delivery at the right time, in the right setting, by following CMS guidelines, escalation of operational barriers, and collaboration with all stakeholders.   Discharge planning will begin at the time of (or prior to) admission, and reassessed ongoing throughout the course of hospitalization in partnership with the clinical team, the patient, and/or the patients representative. Quality and Risk Management issues will also be monitored for and reported as appropriate.

NOTE: Qualified candidates must live in the St. Louis MO area to be considered for this role (this is not a remote work opportunity) 

Primary Responsibilities:

• Takes lead role in directing disposition of patients and utilization considerations
• Assumes leadership role to facilitate interdisciplinary collaboration
• Effectively problem-solves and actively pursues resolution
• Directly communicates with staff, physicians, patients, and families
• Role models leadership behavior through courtesy, respect, and efficiency
• Coordinates patient care processes to achieve desired quality outcomes and identifies/controls inappropriate resource utilization
• Facilitates patient and family education and promotes continuity of care to achieve optimal patient outcomes. Assures patient rights by offering a choice when appropriate
• Reviews the patient plan of care with the multi-disciplinary team. Facilitates and participates in multi-disciplinary team care conferences for patients with complex problems. Communicates in the medical record and verbally with the team to coordinate interventions and facilitate continuity of care
• Daily communication and collaboration with the patient care staff to provide continuous assessment, evaluation, and continuum planning to assure the patient receives the appropriate level of care at the appropriate time. Facilitates the implementation of nursing interventions as indicated by the multi-disciplinary team plan of care that enhances and compliments the skill level of the nursing staff
• Functions without direct supervision, utilizing time constructively and organizing assignments for maximum productivity. Arranges schedule to facilitate meeting with physicians for patient care rounds, team meetings and other opportunities to improve communication

All employees are expected to remain flexible to meet the needs of the hospital, which may include floating to other departments to assist as the patient needs fluctuate.  Must adhere to name badge/dress code compliance.

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:

• Associates or bachelor’s degree in Nursing
• Current, active, and unrestricted Registered Nurse License in the state of Missouri (or compact RN license)
• Live in the St. Louis MO area and willing to travel to multiple hospital locations in the area (this is not a remote work opportunity)
• Ability to provide proof of a valid, unrestricted driver’s license and current auto insurance

Preferred Qualifications:

• Case Management Certification
• Knowledge of post-acute care
• EHR knowledge (specifically EPIC)
• Flexibility of schedule availability

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.