Utilization Management, RN - Honolulu, HI - Full-time / Part-time

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Can you feel it? Bring that energy to a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

As a Utilization Management Nurse you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready for a new path? Join us and start doing your life's best work.(sm)

What makes your nursing career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

Primary Responsibilities:

• Perform utilization management, utilization review, or concurrent review (on-site or telephonic inpatient care management)
  
• Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
  
• Assess and interpret customer needs and requirements
  
• Identify solutions to non-standard requests and problems
  
• Work with minimal guidance; seeks guidance on only the most complex tasks
  
• Translate concepts into practice
  
• Provide explanations and information to others on difficult issues
  
• Coach, provide feedback, and guide others
  
• Act as a resource for others with less experience

Required Qualifications:

• Unrestricted RN license required in state of residence
  
• 3+ years of Managed Care and/or Clinical experience Ability to create, edit, save and send documents utilizing Microsoft Word
  
• Ability to navigate a Windows environment

Preferred Qualifications:

• Pre-authorization experience
  
• Utilization Management experience
  
• Case Management experience
  
• Knowledge of Milliman Critera
  
• Certified Case Manager (CCM)
  
• Undergraduate degree

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(SM)

Diversity creates a healthier atmosphere: 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: UnitedHealth care, Nurse, RN, Registered Nurse, HealthCare, Honolulu, HI, Hawaii