Remote Prior Authorization Review Nurse RN – Las Vegas

UnitedHealthcare

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Requisition Number: 2178792
Job Category: Nursing
Primary Location: Las Vegas, NV
(Remote considered)

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work.(sm)

 

If you are located within Las Vegas, NV (Southern NV), you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

  • Perform clinical coverage review services, which require interpretation of state and federal mandates, applicable benefit language and consideration of relevant clinical information
  • Communicate all types of benefit determinations, including decisions regarding coverage guidelines, contractual limitations and reimbursement determinations
  • Speak to health care providers and/or members to explain benefit coverage determinations and to obtain additional clinical information
  • Act as a resource for others with less experience

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 the state of Nevada
  • Ability to obtain nursing licenses in CA, UT, AZ within 6 months of employment
  • 3+ years of RN experience, including experience in an inpatient / acute setting
  • 1+ years clinical experience as a Registered Nurse
  • Proficient with Microsoft Word to create, edit, save and send documents
  • Proven ability to navigate a Windows environment, Microsoft Outlook, and conduct Internet searches
  • Designated homework space and access to install secure high-speed internet via cable / DSL
  • Applicant must be located in Southern Nevada

 

Preferred Qualifications:

  • Bachelor’s Degree
  • Background involving utilization review for an insurance company or experience in case management
  • Familiarity with InterQual

**Candidates reside within commutable distance to Las Vegas office ** 

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we’re presented with an opportunity to make a difference on a scale we couldn’t imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you’ll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You’ll help write the next chapter in the history of health care. And you’ll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life’s best work.(sm) 

 

Nevada Residents Only: The hourly range for Nevada residents is $27.07 to $53.08. 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.

 

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