Remote Manager Registered Nurse Preservice Review Compact License, TX

Optum

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Requisition Number: 2224654
Job Category: Nursing
Primary Location: Houston, TX
(Remote considered)

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. 

 

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.

 

The Manager Preservice Review is responsible for leading and overseeing the day to day management of the clinical and nonclinical staff within a Clinical Coverage Review team. Responsibilities include management of the inventory, individual staff production, process improvement, service delivery, and quality management.

 

If you have a compact license, you will have the flexibility to work remotely* as you take on some tough challenges.

 

Primary Responsibilities:

  • Manage and increase the effectiveness and efficiency for all operational activity for assigned staff
  • Identifies opportunities to improve operational systems, processes and policies in support of organizational mission and values — specifically, support better management reporting, information flow and management, and business process
  • Measurement of team performance against business unit goals, achieving targeted metrics
  • Demonstrates and teaches critical thinking skills
  • Identifies opportunities to evaluate work and coaches/mentors staff accordingly
  • Works collaboratively with Medical Directors to facilitate Medical Director and staff interaction and problem solving
  • Contribute to short and long-term organizational planning and strategy as a member of the management team, including initiatives geared toward operational excellence
  • Ensure consistent service levels are maintained through managing staffing levels, monitoring metrics, process improvement, and human resource management
  • Participate in quality improvement initiatives focusing on client satisfaction
  • Function as lead or SME in regulatory auditing process
  • Responsible for consistent application of standard policy procedure and regulatory accreditation requirements
  • Monitors clinical staff licensure maintenance per Board of Nursing requirements as well as consistent application of review criteria through annual testing requirements
  • Collaborative relationship with Account Management teams to assure customer satisfaction
  • Be able to work and manage in a virtual team environment
  • Serves as the point person in escalated matters
  • Communicates and collaborates with other members of the care management organization to improve health care quality and efficiency, develop best practices, and identify provider and network issues
  • Participate in Rapid Recruitment process by conducting interviews to fill positions with highly qualified candidates

 

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: 

  • Current unrestricted RN license in state of residence
  • 5+ years of RN managed care and/or clinical experience
  • 2+ years of RN utilization review or case management experience
  • 2+ years of demonstrated supervisory or leadership experience
  • Proven solid computer skills including MS Word, Outlook and Excel
  • Proven excellent communication and people skills

 

Preferred Qualifications:

  • BSN degree
  • Utilization Management or Prior Authorization experience
  • Experience with leading meetings
  • Experience with Quality Improvement Initiatives
  • Experience with Regulatory Requirements

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

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.