Remote Registered Nurse Advisor, Pediatrics – Compact State

Optum

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Requisition Number: 2199352
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.

 

This is a full-time (40 hours/week), Monday – Friday position. Employees are required to have flexibility to work any of our 8-hour shifts during our normal business hours of 8:00am – 8:00pm in their local time zone within a call center setting.

 

If you are located in a Compact State, you’ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Work with members to understand their clinical issues and communicate those issues to providers when necessary
  • Proactively collaborate and solve clinical roadblocks with internal team members and external contacts (i.e., providers) to work through member issues on a case-by-case basis
  • Understand members medical history and to help find support for members with undiagnosed medical complexity
  • Drive team consultation, research, and collaboration to expand the skill set of the team in meeting the diverse needs of individuals with complex health needs
  • Proactively review new, in process, and closed cases to identify opportunities to provide guidance to members and the team
  • Escalate and articulate quality of care concerns to the Medical Director, and collaborate with involved parties to develop solutions and close communication to members
  • Identify and incorporate holistic environmental and cultural factors that impact the health and experience for our members and families
  • Identify priorities to address business and operational challenges interfering with the needs of the members
  • Demonstrate active, empathetic listening to develop solutions with members, multidisciplinary providers, and internal team
  • Relay complex information across teams and to members in a plain, clear manner
  • Continually provide feedback and insight on process improvements

 

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 and unrestricted RN License in your state of residence
  • Multiple state licensures (in addition to a Compact License if applicable) OR ability to obtain multiple state nursing licenses
  • 3+ years of experience working directly with complex pediatric patients and families
  • Proficient in multitasking and navigating multiple computer programs simultaneously while talking on the phone
  • Proficient with Microsoft Outlook, Word, and Excel
  • Access to high-speed internet with minimum upload/download speeds of 13 MBPS/20 MBPS via Cable Broadband, DSL, or Fiber
  • Dedicated, distraction-free home office/workspace
  • Reside within 50 miles of a UnitedHealth Group office

 

Preferred Qualifications:

  • Bachelor’s degree
  • Certified Case Manager (CCM)
  • Case management experience
  • Complex case management experience
  • Managed Care experience
  • Relationship management experience
  • Genuine passion for children and families
  • Ability to dig deep, proactively anticipating not just medical but also system processes and issues
  • Ability to effectively navigate the healthcare system
  • Familiarity with systems including but not limited to ISET, ICUE, and PHMC

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $56,300 to $110,400 per year. 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