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NRSKarenRN Great website...thanks for the tip

Here is the United HC job posting Telephonic RN Case Manager Opportunities-Tampa, FL Job Description UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health. OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. If you want more meaning in your career - as a clinician or a business professional - think of OptumHealth as your calling. By providing 60 million Americans with information, tools and solutions, we are helping to guide them through the health care system, financing their health care needs, and enabling them to achieve their personal health and well-being goals. As a Telephonic Case Manager, you will be responsible for clinical operations and medical management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating. This may include case management, disease management, coordination of care and medical management consulting. You will also be responsible for providing health education, coaching and treatment decision support for members. **Afternoon Shift 10am-9pm. Primary responsibilities: Making outbound calls to assess members' current health status Identifying gaps or barriers in treatment plans Providing patient education to assist with self management Interacting with Medical Directors on challenging cases Coordinating care for members Making referrals to outside sources Coordinating services as needed (home health, DME, etc) Educating members on disease processes Encouraging members to make healthy lifestyle changes Documenting and tracking findings Utilizing Milliman criteria to determine if patients are in the correct hospital setting Making "welcome home" calls to ensure that discharged member receive the necessary services and resources At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined. Job Requirements Qualifications: Current, unrestricted RN license in the State of FL 2+ years experience in a hospital setting, acute care, direct care experience OR experience as a telephonic Case Manager for another insurance company Computer proficiency including the ability to type and talk at the same time and to navigate a Windows environment Must live within a commutable distance of the Tampa, FL office Additional Assets Preferred: BSN A Background in managed care Certified Case Manager (CCM) Cardiac experience preferred Experience /exposure with discharge planning Experience in utilization review, concurrent review and/or risk management Strong organizational skills and multitasking abilities will be keys to success

here is a telephonic case management position in tampa, florida: general summary: general summary responsible for telephonically assessing, planning, implementing and coordinating all case management activities associated with an injured employee to evaluate the medical and disability needs of an injured worker and facilitate the patient's appropriate and timely return to work. acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel. essential responsibilities -- works telephonically with workers' compensation patients, employers, providers, and claims adjusters to coordinate and assure proper delivery and oversight of medical and disability services. -- performs pre-certification process for prescribed treatment by gathering relevant data and information through clinical interviews with the injured employee, provider(s), and the employer. -- evaluates and coordinates medical and rehabilitative services using cost containment strategies. plans a proactive course of action to address issues presented to enhance the injured employee's short- and long-term outcomes. -- assesses and identifies barriers to recovery; determines goals, objectives, and potential alternatives to care. works as an advocate to promote the injured employee's best interest, addressing treatment alternatives, coordination of quality, cost effective health care and rehabilitative services. -- assists the injured employee by providing medical and disability education and coordinating on-site job analysis, work conditioning, functional capacities, and ergonomic evaluations. -- negotiates and assists employers with the development of transitional sedentary or modified job duties based on the injured employee's functional capacity to ensure the injured employee's safe and timely return to work. -- monitors, evaluates, and documents case management activities and outcomes including, but not limited to, case management approaches, over or under utilization, inappropriate care, effective treatment, permanent or temporary loss of function, failed or premature return to work, and non-compliance. -- adheres to all appropriate privacy, security and confidentiality policies and procedures. -- performs other duties as assigned. learn more about coventry health care job requirements include: job specifications rn with current state license required. -- previous (2 or more years) general clinical experience required. -- bachelor's degree or equivalent experience preferred. -- ccm, crrn, cohn, or cdms eligibility or current certification encouraged. these designations are required where dictated by state law. -- previous workers compensation, case management, utilization review or managed care experience preferred. -- strong problem solving and analytical skills. -- demonstrated communication, organizational, and interpersonal skills. this position is on-site for client/customer. -- must be computer proficient we provide competitive salaries, excellent benefits and a desirable work environment.

United Health Care Systems

There are many case management positions and companies in the Tampa area 1. Blue Cross/Blue Shield (although I don't recommend this company) 2. United Healthcare 3. Baycare hospital systems 4. Coventry 5. Work comp case management companies

I worked for Blue Cross and Blue Shield in Tampa Florida: I worked both in the precert/UR department (3 months) and Case Management (3 months) Precert Department: I have never in my life worked in such a negative environment. 90% of the employees (mostly nursing) hated every moment being there. The job was a cake walk....very easy and extremely boring. The managers were nice but again it was the co-workers and the fact that they hated every aspect of the job. Since it was a temp position, I elected not to come on permanently as a direct hire. Case Management (Telephonic): I was a direct hire for this position and I have to say that the manager was a nut. She was constantly hugging me when she came in and all happy but then was flipping out in the next moment. I meet some really great nurses on my team which was a plus, but as far as the job itself, I did not like performing medical case management. I am not sure if it is the company itself or the job......BUT it was very depressing to interact with patients and when they do not have insurance coverage for some necessity for medical care, then I was directed "well that is all we can do". I am not that kind of nurse. I would research other resources in the community but I was told not to spend time on that. The whole company attitude was extremely poor. The attitude for medical director reviews was "well, how many denials have I had this week". I am sorry, but I don't agree that the mentality there. As far as telephonic case management in general (I went on to accept a work comp telephonic nurse position) and I have been with the company for over 5 years. I truly love my job. And yes, you can be very effective working telephonically. Case Management is a wonderful and instrumental field if you are with a company that truly values what it is that you can offer. Good Luck