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Preservice Review Nurse RN (Telecommuting in Brentwood, TN)
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Brentwood, TN Brentwood, Tennessee |
About this job
Want to learn more before applying for this role? Click here to view the Realistic Job Preview:
This Preservice Review Nurse is a Telecommuting role in the Brentwood, TN area! Hours are Monday-Friday, 9:00am-5:30pm
Responsibilities include:
- Perform utilization and concurrent review using Milliman criteria
- Conduct clinical chart assessments
- Discuss cases with treating physicians and other healthcare professionals to better understand plans-of-care
- Identify and evaluate delays in care
- Initiate a discharge planning and readmission prevention plan when applicable
- Approve bed days for inpatient cases when applicable
- Arrange alternative care services; Contact and maintain communication with acute long term care, acute rehabilitation, or skilled nursing facilities to move patients through the care continuum
- Gather clinical information to assess and expedite care needs
- Maintain appropriate documentation
- Consult with the Medical Director as needed to troubleshoot difficult or complex cases
- Participate in telephonic and in-person staff meetings
What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in 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.
Requirements
Requirements:
- RN - current and unrestricted license in TN
- 3+ years of clinical experience
- Previous hospital experience
- MS Word, Excel, Outlook expertise
- Strong communication skills
- Excellent organizational skills
- Team-oriented
- Must live within a commutable distance of the Brentwood, TN office
Additional Assets Preferred:
- BSN
- Prior authorization/UM/Case Management experience
- Experience in managed care
- Medicare/Medicaid expertise
- Knowledge of DME services
- Long term care 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
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.