UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others. Join us to start Caring. Connecting. Growing together.
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.
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.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. 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
Demonstrate a proficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platforms
Designated workspace and access to install secure high-speed internet via cable / DSL in home
Background (1+ years) that involves utilization review and evidence-based guidelines (InterQual Guidelines)
2+ years case management experience
Managed Care experience
Experience performing discharge planning
Ability to work independently
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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 annually. 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.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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.