30 days old

Float Case Manager-Ontario Corona and San Bernardino

Ontario, CA 91764
  • Job Code
    876397
North American Medical Management, California, Inc. (NAMM California) partnered with OptumCare in 2012. NAMM California and OptumCare share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and manages provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform.

The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets.
North American Medical Management, California, Inc. (NAMM California) partnered with OptumCare in 2012. NAMM California and OptumCare share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and manages provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform.

Schedule: Monday-Friday 8am-5pm

Primary Responsibilities:
  • Daily telephonic or onsite rounds, reviewing of medical records, concurrent review, and discharge planning on inpatients with arrival at facilities in the morning
  • Reviews inpatient cases with UM Manager on a daily basis 
  • Documents Milliman Guideline(s) on every inpatient case within 24 hours of receipt and updates guideline as hospitalization 
  • Explores care options to reduce cost, decrease length of stay, curtail readmission and influence quality outcomes 
  • Understands full vs. shared risk 
  • Generates authorizations utilizing principles of UM 
  • Identifies and refers members to Case Management prior to discharge or as deemed appropriate through referral review

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.

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Posted: 2020-06-04 Expires: 2020-08-02

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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Float Case Manager-Ontario Corona and San Bernardino

UnitedHealth Group
Ontario, CA 91764

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