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.** The **Case Manager Nurse** in Optum Frontier Therapies will directly support our clinical model serving patients with rare diseases by developing relationships with patients while conducting assessments specific to their therapy. This role will be under direct supervision from the Site Director, Operations. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Conduct comprehensive patient level assessments over the phone with documentation in proprietary platform + Conduct meaningful conversations with patients and their caregivers to understand the need for interventions to enhance their overall health outcomes and develop care plans + Manage inbound and outbound calls from patients and caregivers while maintaining quality services levels + Develop relationship with clinical pharmacist staff as partners in the overall care continuum of the patient + Communicate with providers office and their staff as appropriate for patient needs + Conduct adverse event, product complaint, and special situation conversations with patient. Document and engage with clients as appropriate per program requirement. + Adheres to all operations, practices and procedures to meet all licensing and standards requirements established by local, state and federal agencies as well as accrediting bodies (e.g. ACHC, URAC) + Ensures compliance with all controlled substances related rules, regulations, company policies and maintains proper communication and coordination with other departments and staff + Compliance to and education for all accreditation programs including ACHC, URAC, etc. + Monitors for compliance with all HIPAA regulations, adherence to all State and Federal regulations and laws, accrediting bodies, adherence to all pharmacy accepted standards of practice + Willingness to support clinical functions including prior authorization and appeal reviews, override requests, and inbound and outbound patient and provider education calls. + Provides insight to platform improvement(s) and process improvement(s) + Willingness to obtain all licenses as required to service patients living in any state or territory + Completes special duties or projects as assigned by leadership 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:** + An unencumbered Registered Nurse in the state of residence + Nurse Licensure Compact (NLC) + Bachelor of Science in Nursing (BSN), Associate Degree in Nursing (ADN) or Diploma in Nursing + 5+ years of experience in patient facing field + Proven solid verbal and written communication skills, interpersonal relationship skills + Proven exceptional organizational, time management skills working toward hard deadlines to meet key performance metrics + Proven excellent troubleshooting, problem solving and interpersonal skills effective with multiple levels / professional disciplines as well as patients, families, staff and physicians + Proven team player and collaborate across functions **Preferred Qualifications:** + Multistate licensure in state(s) not participating in Nurse Licensure Compact + Experience in the rare disease space + Experience with telephony-based care services + Baseline proficiency in the entire prior authorization and appeals process for specialty prescription medications, infusions, medical procedures and devices to provide cross functional support as deemed appropriate *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _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._