Remote Utilization Management RN – AZ

Optum

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Requisition Number: 2225688
Job Category: Nursing
Primary Location: Phoenix, AZ
(Remote considered)

$5,000 Sign on Bonus for External Candidates

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. 

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 at UnitedHealth Group, you will make sure our health services are administered efficiently and effectively. You’ll assess and interpret member needs and identify solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready to make an impact

***Although this position is remote, applicants must work Arizona time 8am-5pm PST/MST depending on time of year***

It feels great to have autonomy, and there’s also a lot of responsibility that comes with it. In this role, you’ll be accountable for making decisions that directly impact our members. And at the same time, you’ll be challenged by leveraging technologies and resources in a rapidly changing, production-driven environment.

If you have the ability to work PST & MST time , you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities: 

  • Positions in this function require unrestricted RN licensure
  • Function is responsible for utilization management which includes Concurrent Review (on-site or telephonic Inpatient Care Management). Performs reviews of current inpatient services
  • Determines medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
  • Generally, work is self-directed and not prescribed
  • Works with less structured, more complex issues
  • Identify solutions to non-standard requests and problems
  • Translate concepts into practice
  • Act as a resource for others; provide explanations and information on difficult issues

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: 

  • Unrestricted RN license required in state of residence
  • Compact RN License
  • 3+ years of managed care and/or clinical experience
  • Proven basic computer skills with MS Outlook, Word and Excel
  • Able to work 8am-5pm Arizona Time Zone

Preferred Qualifications:   

  • Certified Case Manager (CCM)
  • Pre-authorization experience
  • Multi-specialty experience
  • Multiple EMR experience including Epic, Cerner, TMC, Meditech or Care Advance
  • Utilization management experience
  • Case management experience
  • Knowledge of Milliman criteria

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

Nevada, Washington, California or Colorado Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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. 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.