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 Oncology Case Manager / Utilization Manager RN - Downers Grove, IL or - DOWNERS GROVE, Illinois, United States

Job information
Posted by: UnitedHealth Group 
Hiring entity type: Insurance 
Work authorization: Existing work authorization required for United States
Position type: Direct Hire, Full-Time 
Compensation: ******
Benefits: See below
Relocation: Not specified 
Position functions: Nursing - Case Management
Nursing - Clinic RN
Nursing - Other
Nursing - Staff RN
Travel: Up to 25% 
Accept candidates: from anywhere 
Languages: English - Fluent
Spanish - Fluent
Minimum education: See below 
Minimum years experience: See below 
Resumes accepted in: English
Cover letter: No cover letter requested
Job code: 757890 / Latpro-3602905 
Date posted: Mar-15-2018
State, Zip: Illinois, 60515


The Optum Oncology Case Manager will help ensure patients receive high-quality, evidence-based and cost-efficient oncology care.  As such, this role requires an engaging, action-oriented clinician.  This role will serve as a key component in the implementation of Optum's next-generation oncology programs. This position will be located onsite in our Downers Grove, IL location OR can be telecommute / work from home from anywhere in US.  There will be potential travel up to 10% of the time to Downers Grove, IL or Minnesota for quarterly meetings or as needed.   This position offers the potential to work at home. Work schedule expectations offer some flexibility with a combination of day and consumer hours.       You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.   Primary Responsibilities: Support the Oncology Medical Director in the creation, implementation and refinement of an Oncology utilization management program Serve as a subject matter expert in evidence-based oncology guidelines - especially those produced by the National Comprehensive Cancer Network (NCCN) - and help interpret them to write clinical guidelines, job aides, and decision trees. These items will help ensure the program's policies and processes are informed by the best available evidence Perform utilization review determinations for oncology  populations (includes evaluating appropriateness and efficiency of requested health care services, procedures, and cancer treatments under the provisions of the applicable health benefits plan) Engage with providers via outbound calls to assess patient's current health status and coordinate care Identify gaps or barriers in patient treatment plans (based on evidence-based guidelines) Collaborate with Medical Directors on challenging cases Document and track findings This position will require active and unrestricted Nursing licensure in multiple US States.  Selected candidate must be willing and able to obtain and maintain multiple state licensure. (Application fees and filing costs paid for by UHG)  


Required Qualifications: 

Active, unrestricted RN license in the state of residence
Multiple state licensure (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses required
3+ years of Oncology experience in a Hospital setting, Acute Care, Direct Care experience or experience as an Oncology Telephonic Case Manager for an insurance company
Experience working with NCCN (National Comprehensive Cancer Network) guidelines
Chemotherapy administration experience
Access to high speed internet and dedicated work space from home
Preferred Qualifications: 

OCN or other oncology related certifications

Experience in medical care delivery systems, utilization management, case management, disease management, quality management, and/or product development
A background in managed care
Certified Case Manager (CCM)
Bilingual (Spanish/English) skills
Computer proficiency, to include strong data entry skills and the ability to navigate a Windows environment  

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*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
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: Oncology, Cancer, Case Manager, Care Coordinator, Utilization Management, Utilization Review, RN, Nurse, Chemotherapy, National Comprehensive Cancer Network, NCCN, OCN, CCM, Downer's Grove, IL, Illinois, telecommute


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