Telephonic Utilization Management Nurse RN

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 is currently staffing for a Telephonic Utilization Management Nurse RN. The Utilization Management Nurse responsibilities include:

* Performs utilization management, utilization review, or concurrent review (on-site or telephonic inpatient care management)

* Determines medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination

* Assesses and interprets customer needs and requirements

* Identifies solutions to non-standard requests and problems

* 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

Basic Requirements:

* Unrestricted RN license required in state of residence

* Minimum of 3 years of Managed Care and/or Clinical experience required

* Basic level of experience with Microsoft Word, Excel, Outlook, and Internet

Additional Assets Preferred:

* Experience placing people in skilled nursing and LTAC settings (Post acute care)

* Discharge planning

* Pre-authorization experience

* Case Management experience

* Certified Case Manager (CCM)

* Undergraduate degree  

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: UR, UM, Concurrent Review, Telephonic, Work at home, Work from home, Utilization Management