RN Case Manager - Field Based - St. Louis, MO

    • St. Louis, MO

Position Description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

The RN functions as part of the primary care team, and reports to the Clinical Services Manager. The RN performs activities that fall within the RN scope of practice. This role works in close collaboration with all of the team members, and may support multiple providers. The RN understands and supports the ISNP models of care, and works in collaboration with the team to meet the goals of the program.

This is a field based position that will require travel between skilled nursing facilities in the St. Louis, MO greater area.

Monday - Friday, days

Primary Responsibilities:

  • New Enrollees: Reviews nursing home medical records and forwards them to the pree team for entry into Pathway (EMR) to facilitate NP initial visit
  • Makes nursing home rounds to identify high acuity patients
  • Researches and follows up on HEDIS / Medicare Star Quality measures and collaborates with NP to meet requirements and close gaps in care
  • Functions as part of the overall team and is accountable for supporting the team in meeting team and market goals
  • Assist in completing assessments for lower acuity members
  • Provide education to nursing home facility staff


Required Qualifications:

  • Current RN license in the state of Missouri
  • 3+ years of nursing experience
  • Experience with care coordination
  • Strong assessment skills
  • Strong Microsoft Office skills
  • Experience with using an Electronic Medical Record


Preferred Qualifications:

  • BSN
  • Familiarity with the long term care business environment
  • Experience with HEDIS quality measures
  • Experience with medical record chart reviews / audits
  • Experience working with the geriatric population
  • Acute and / or Long Term Care experience
  • Excellent critical thinking skills
  • Excellent oral and written communication skills
  • Detail oriented, able to multi - task and remain flexible with assignments
  • Ability to work independently and be self - driven in an environment that includes a variety of personalities and skill sets


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do 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, HEDIS, quality, long term care, nursing home, medical review, audit, geriatric, St. Louis, MO, Missouri


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