Utilization Management RN $3K Sign on Bonus - Irvine, CA

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

Primary Responsibilities:

• Processing of pre-service authorization requests for a specific line of business


• Utilization management which includes Concurrent Review


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


• Work is self-directed and not prescribed

Required Qualifications:

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  Must be familiar with regulatory requirements; turn- around times; criteria such as MCG (Milliman) guidelines


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  Candidate must be able to work in a high paced environment


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  Strong computer skills


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  Able to make clinical decisions and work effectively as part of a team


• Licensure includes RN or LPN/LVN, depending on grade level, with current unrestricted licensure in applicable state


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  Undergraduate degree or equivalent experience

Preferred Qualifications:

• Prefer RN; would consider LVN if experienced


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  Candidate would need to be flexible and willing to work a Saturday when / if needed to cover the business needs and requirements

What's the first thing that happens when one of the most successful physician groups in Orange County comes together with a global leader in health care? Opportunity. With Monarch HealthCare joining Optum and the UnitedHealth Group family of companies, people like you will find increasing levels of challenge, impact and professional success. With a vibrant network of hospitals and urgent care centers, we're changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. That takes passion, commitment, intense focus and the ability to contribute effectively in a highly collaborative team environment. Are you with us? Learn more about this exciting opportunity 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.

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