Job Description

Monarch HealthCare is one of the largest associations of physicians and health care professionals in Orange County and Long Beach. Our network gives you lots of access to specialists, hospitals, skilled nursing, urgent care and more so you have the perfect fit for good health. Monarch is part of OptumCare, a care delivery organization that improves patient health and helps make health care work better.

The RN Case Manager is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting

Schedule: Monday - Friday 8:00am - 5:00pm. No nights, weekends or holidays.

*Allowing 100% remote capacity through the COVD-19 pandemic. The regional office is located in Irvine, CA and the person is expected to work on-site daily, post COVID-19 pandemic

Primary Responsibilities:

* Provides health education and coaches consumers on treatment alternatives to assist them in best decision making
* Supports consumers in selection of best physician and facility to maximize access, quality, and to manage heath care cost
* Coordinates services and referrals to health programs
* Prepares individuals for physician visits
* Assesses and triages immediate health concerns
* Manages utilization through education
* Identifies problems or gaps in care offering opportunity for intervention
* Assists members in sorting through their benefits and making choices

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:

* Current, unrestricted RN license for state California
* 3+ years of Clinical RN experience
* 1+ years of experience in case management
* Intermediate computer skills (Microsoft Word, Outlook and Internet)
* Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive VoiceResponse (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
* You will be provisioned with appropriate Personal Protective Equipment (PPE) and are required to perform this role with patients and members on site, as this is an essential function of this role

Preferred Qualifications:

* Ambulatory / telephonic case management experience
* Experience working with Pediatric population
* Medi-Cal / Medicaid experience
* Knowledge of community resources for pediatrics
* Bilingual Spanish

What's the first thing that happens when one of the most successful physician groups in Orange County comes together with a global leader in health care? Opportunity. With Monarch HealthCare joining OptumCare and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. With a vibrant network of hospitals and urgent care centers, we're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting 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: UM RN, Monarch, case management, RN Case Manager, case manager, hospital, acute care, telephonic, Monarch, Irvine, CA, California