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UnitedHealth Group Utilization Management Nurse Telecommute in Scottsdale, Arizona

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 a Utilization 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.

If you are located in Arizona, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Perform utilization management, utilization review, or concurrent review (on - site or telephonic inpatient care management)

  • Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination

  • Assess and interpret customer needs and requirements

  • Identify solutions to non - standard requests and problems

  • Work with minimal guidance; seeks guidance on only the most complex tasks

  • Translate concepts into practice

  • Provide explanations and information to others on difficult issues

  • Coach, provide feedback, and guide others

  • 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 residence

  • 3+ years of experience in an acute care setting

  • Knowledge of utilization management, quality improvement, discharge planning with transitions of care

  • MCG certification, if does not have certification, must obtain within 2 years of hire

  • Experience using EMR, utilization management and / or prior authorization systems

  • Ability to work 8am-5pm MTN zone

  • You will be required to adhere to UnitedHealth Group’s US Telecommuting Policy.

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

  • Experience working with Medicare members

  • MCG utilization management experience

  • CCM certification or must obtain within 2 years of hire

  • Working knowledge of hospice and palliative care

  • Working knowledge of SNF & LTAC facilities

  • Bachelor’s degree in nursing (BSN)

  • Possess planning, organizing, conflict resolution, negotiating and interpersonal skills

  • Experience with Microsoft Office

  • Independent problem identification / resolution and decision making skills

  • Able to prioritize, plan, and handle multiple tasks / demands simultaneously

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Job Keywords: Utilization Management Nurse, RN, Arizona, AZ, Phoenix, Mesa, Scottsdale, Telecommute