Internal Number: 136159361 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.If putting a smile on someone's face puts one on yours, you belong on our team. Here at Optum Puerto Rico Operations, we've brought together teams of incredibly compassionate and positive people to help serve our members or providers when they reach out to us with questions. Your helpful personality combined with our support, training and development will ensure your success. This is no small opportunity. This is a chance to leverage your compassion for others and build a rewarding career.These roles identify, coordinate, or provide appropriate levels of care. Function 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. Function may also be responsible for providing health education, coaching and treatment decision support for members. Includes Health Coach, Health Educator, and Health Advocate roles that require an RN.Primary Responsibilities:Making outbound calls and taking inbound calls to assess members' current health statusIdentifying gaps or barriers in treatment plansProviding patient education to assist with self - managementInteracting with Medical Directors on challenging casesCoordinating care for membersEducating members on disease processesEncouraging members to make healthy lifestyle changesDocumenting and tracking findingsMaking post - discharge calls to ensure that discharged member receive the necessary services and resources***ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION***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:Associate Degree or Bachelor's degree in NursingRegistered Nurse with Puerto Rico LicensureNCLEX Certification 3+ years of clinical experienceWindows PC navigation proficiency or higher and ability to navigate in multiple systemsBilingual (Spanish / English) skillsPreferred Qualifications:Unrestricted NCLEX licensure specially in the state of FL, PA and ILCertified Case Manager (CCM)Medical / Surgical, Home Health, Diabetes or Cardiac experience or certificationCase Management experienceOncology experienceExperience working with Medicare / geriatric patientExperience / exposure with discharge planning 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.
