The job below is no longer available.

You might also like

in New York, NY

Use left and right arrow keys to navigate
Hours Full-time, Part-time
Location New York (Manhattan), NY
New York, New York

About this job

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.


Want to learn more before applying for this role? Click here to view the Realistic Job Preview:  


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

Requirements

Required Qualifications



  • Unrestricted RN license required in state of residence
  • 3 + years of Managed Care and/or Clinical experience required
  • 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 Criteria
  • Certified Case Manager (CCM)
  • Undergraduate degree

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, Utilization Review, Utilization Management, Concurrent Review, Milliman, Interqual, Managed Care, Insurance, Case Management, Case Manager, Discharge Planning, Chart Review, Pre-Authorization, New York, Manhattan, NY