Utilization Management Nurse/ Discharge Planner, Mississippi

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)

The UnitedHealth Care Community & State Utilization Management Nurse/ Discharge Planner assumes an integral role with successful discharge planning when members return to the community or transfer to a lower level of care to help reduce acute hospital days.

This is a work from home opportunity which requires residency in the State of Mississippi. 

Work schedule: Monday - Friday 8AM - 5PM CST  

Utilization Management Nurse/Discharge Planner responsibilities include:

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  Outreaches to MS CAN and MS CHIP to prevent readmissions


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  Collaborates with providers and members to coordinate care services for members that are being discharged or changing a level of care


• Assesses and interprets customer needs and requirements


• Identifies solutions to non-standard requests and problems


• Solves moderately complex problems and/or conducts moderately complex analysis


• Works with minimal guidance; seeks guidance on only the most complex tasks


• Translates concepts into practice


• Provides explanations and information to others on difficult issues


• Coaches, provides feedback, and guides others


• Acts as a resource for others with less experience


• Assists members to navigate the complexities of the health care system


• Develop knowledge of community resources and alternate funding arrangements available to members when services are not available under benefit program


• Reports incidents to internal department by identifying Quality Indicators and Sentinel Diagnoses as they occur


• Works in a multidisciplinary team with emphasis on medical management of the member during a transition of care

Requirements:

• Unrestricted RN license required in state of Mississippi


• 1 or more years of recent UM/UR and/or Discharge Planning experience in a hospital setting


• 3 or more years of combined experience with Pediatrics and Medical/Surgical experience


• Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment, Excel spreadsheets

Additional Assets Preferred:

• Pre-authorization experience


• Case Management experience


• Undergraduate degree


• Managed Care or Medicaid experience

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.



UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Keywords: RN, Registered Nurse, Discharge Planner, Case Manager, Utilization Review, Utilization Management, Pediatrics, Medical/Surgical, Med/Surg, Managed Care, Medicaid, Work from Home, Telecommuter, Jackson, Southaven, Mississippi, MS