UnitedHealth Group Inpatient Care Management Nurse RN - Telecommute in EST, CST in Overland Park, Kansas
There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Can you feel it? Bring that energy to a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready for a new path? Join us and start doing your life's best work.(sm)
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.
Work schedule will be Monday-Friday from 8am-5pm Central Time or Eastern Time.
If you live within EST or CST, you will enjoy the flexibility to telecommute* as you take on some tough challenges.
Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (InterQual criteria)
Discuss cases with facility healthcare professionals to obtain plans-of-care
Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management
Participation in discussions with the Clinical Services team to improve the progression of care to the most appropriate level
Consult with the Medical Director, as needed, for complex cases and make appropriate referrals to downstream partners
Apply clinical expertise when discussing case with internal and external Case Managers and Physicians
Identify delays in care or services and manage with MD
Follow all Standard Operating Procedures in end to end management of cases
Obtain clinical information to assess and expedite alternate levels of care
Facilitate timely and appropriate care and effective discharge planning
Participate in team meetings, education, discussions, and related activities
Maintain compliance with Federal, State and accreditation organizations
Identify opportunities for improved communication or processes
Participate in audit activities and meetings
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.
Current, unrestricted RN license
3+ years of clinical nursing experience practicing clinically (Acute Inpatient, SNF/AIR/LTAC, Emergency Department, Urgent Care, Doctor’s Office, School Nurse)
Experience in acute, long term care, acute rehabilitation, or skilled nursing facilities
Proficient computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platforms
Must have a designated workspace and access to install secure high-speed internet via cable/DSL in home
Able to work EST or CST hours
1+ years of experience involving utilization review and evidence-based guidelines (i.e. MCG, InterQual Guidelines)
Managed Care experience
Experience performing discharge planning
Familiarity with InterQual criteria guidelines
Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Colorado Residents Only: The salary range for Colorado residents is $53,300 to $95,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.
Job Keywords: Utilization Review, Utilization Management, concurrent Review, MCG, Milliman, Interqual, UM, UR, RN, Registered Nurse, Inpatient, Discharge Planning, critical care, acute, long term care, acute rehab, Telecommute, Remote, Work from Home