Pre-Service Coordinator - National Remote

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 12:00pm – 9:00pm CST. It may be necessary, given the business need, to work occasional overtime or weekends. 

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Perform in a hybrid role as either clinical “gatherer and authorization document creator” or solely as a clinical and authorization “reviewer” for all prospective, concurrent, and retrospective requests within established parameters.


• Perform review for all direct admits to SNF via physician office, ED or HH.


• Perform all expedited prospective reviews, including patient oral and/or written notifications.


• Perform all standard prospective reviews, including patient oral and/or written notifications.


• May have EMR access to mirror Inpatient Care Coordinator partner access.


• Coordinator peer to peer reviews with naviHealth Medical Directors.


• Notify hospitals and SNFs of review outcomes for non-engaged patients.


• Partner with Medical Directors for Pre-Service Coordinator training as needed.


• Complete processes as it relates to pre-service authorizations.


• Educate facilities on the pre-service denial process.


• Participate in the clinical phone queue to ensure customer SLA’s are met.


• Support new delegated contract start-up to ensure experienced staff work with new contracts.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• Bachelors Degree (or higher)


• Active, unrestricted registered clinical license required – Registered Nurse, Physical Therapist, or Occupational Therapist


• 3+ years of clinical experience


• Ability to work 12:00pm – 9:00pm CST

Preferred Qualifications

• Experience in acute care, rehab or skilled nursing facility environment


• 2+ years of Case Management experience


•  Managed Care experience 


• Experience performing clinical audits to improve quality standards or performance


• Experience working with geriatric population


• ICD-10 and InterQual experience


• CMS knowledge

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy


• Ability to keep all company sensitive documents secure (if applicable)


• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

• Strong critical thinking skills and the ability to review patients’ clinical information holistically


• Flexible and willing to work an early or late shift and/or longer than normal hours to accommodate peaks in volume of work


• Exceptional verbal and written interpersonal and communication skills


• Experience in oversight and supervision of assistants (CNAs, PTAs, OTAs)


• Ability to work effectively in a self-management environment


• Experience with physician engagement and crucial conversations


• Strong technical/computer skills


• Excellent documentation skills required


• Self-starter with the ability to prioritize daily workload


• Readiness to embrace a fluid, changing, and fast-paced environment

Physical and Work Environment:

• Ability to establish a home office workspace


• Ability to manipulate laptop computer (or similar hardware) between office and site settings


• Ability to view screen and enter data into a laptop computer (or similar hardware) within a standard time period


• Ability to communicate with clients and team members including use of cellular phone or comparable communication device

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / New Jersey / New York / Washington / Rhode Island residents is $67,800 - $133,100.Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and 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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