Preservice Review Nurse - Telecommuting! - Full-time / Part-time

Preservice Review Nurse!  Telecommuting!  Are you
ready for your next challenge? Discover it here at UnitedHealthcare and
help us reinvent the health system. This can be your opportunity to take
on 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. You will
discuss cases with treating physicians and other healthcare
professionals to ensure our members receive the proper health services.
You will be required to maintain communication with acute long term
care, acute rehabilitation, or skilled nursing facilities in order to
help patients through their care plan. This is an exciting opportunity
at a truly inspired organization. Join us. This can be the start of 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.
 
Tuesday - Saturday;  Shift will be either 8:30 AM - 5 PM or 9 AM - 5:30 PM

As a Preservice Review Nurse, your duties will include:  
Perform utilization review using Milliman (MCG) criteriaDiscuss cases with treating physicians and other healthcare professionals to better understand plans-of-care Approve bed days for inpatient cases when applicableGather clinical information to assess and expedite care needs Consult with the Medical Director as needed to troubleshoot difficult or complex cases

Required Qualifications:
Unrestricted, active RN license3 years RN experience in an acute settingAbility to create, edit, save and send documents utilizing Microsoft WordAbility to navigate a Windows environment and conduct Internet searchesMust be able to have internet connected to your home officeMust be able to work the posted shift
Preferred Qualifications:
Utilization management, prior authorization, and case management experience Working knowledge of Milliman (MCG) or InterQual BSNMedicaid experienceUnderstanding of DME Prior AuthorizationICD 9 or ICD 10 coding is a plusDiagnostic or procedure coding (CPT coding)Critical Care Experience
Careers with UnitedHealthcare.
Let's talk about opportunity. Start with a Fortune 14 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)
 
 
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: RN, Registered Nurse, UR, UM, Pre-Authorization, Utilization
Review, Utilization Management, Milliman, MCG, InterQual, Managed Care, Insurance, Health Insurance, Case
Management, Case Manager, Chart Review, telecommute, work from home, Medicaid,  UHG, UnitedHealth Group, UHC, Unitedhealthcare