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Registered Nurse Care Manager, Community - Rockville, MD (office based position)

UnitedHealth Group

Rockville, MD
Job Code:
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Job Details

736752 Registered Nurse Care Manager Community Rockville MD office based position

Registered Nurse Care Manager, Community - Rockville, MD (office based position) (736752)

Position Description

Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm)


The Nurse Care Manager (NCM) supports the primary visiting provider (PVP) in assessing and managing the overall patient care management process.  In addition, the Nurse Case Manager will identify and collaborate on innovative actions to meet the needs of OPTUM patients from both the health care and psychosocial / socioeconomic dimensions of care; as well as taking action for provision of services to meet the patient needs. The NCM provides oversight, guidance and support for the patient care plan as developed in collaboration with the PVP. This care plan is based on the comprehensive history & physical completed by the PVP and the nursing assessment. The NCM uses both assessments and ongoing telephonic assessments to help guide treatment and care decisions of the team with a focus on trigger management to prevent adverse outcomes.  In addition the NCM collaborates with the health plan and additional heath care vendors to meet the needs of the patient and also identifies services and vendors for needed care while navigating patient benefit plans.

The Nurse Case Manager will ensure that all pertinent documentation is in the medical record in a manner compliant with CMS, OPTUM and client requirements. 
Primary Responsibilities:
  • Conduct initial and ongoing assessments utilizing nursing assessment skills
  • Develop and implement an effective care plan to meet the needs of OPTUM community patients from both the health care and psychosocial / socioeconomic dimensions of care
  • Advocate for the patient in all activities including nursing assessments, care coordination, care plan development, and communication.
  • Identify triggers for hospitalization and develop (in collaboration with members of the care team) an effective care plan
  • Communicate and collaborate with other members of the health care team (PCP, PVP, CMA, health plan) to coordinate all needed care and service
  • Provide ongoing patient education leveraging written material as available/approved by the health plan
  • Provide ongoing support of patients with advance care planning
  • Provide 24/7 support for the PVPs as needed

Required Qualifications:

  • Active un-encumbered license to practice nursing in the state
  • 3+ years nursing experience
  • Understanding of Medicare, Medicaid and Health Plan benefit structures beneficial
  • Basic knowledge of computers and cell phones
  • Familiarity with ICD-10 and CPT-4 coding  
  • Excellent organizational skills with the ability to multi-task
  • Must have experience working within a team environment

Preferred Qualifications:

  • Case Management certification
  • Bi-lingual or multi-lingual
  • 1+ year of case management experience
  • Managed care, utilization management, risk management, quality management, case management experience

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 Jobs, Case Manager, RN, home care, senior care, Rockville, Maryland, MD


Job Details

  • Contest Number736752
  • Job TitleRegistered Nurse Care Manager, Community - Rockville, MD (office based position)
  • Job FamilyNursing
  • Business SegmentOptumCare

Job Location Information

  • Rockville, MD
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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