Inpatient Care Management Nurse RN - Remote at UnitedHealth Group

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 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.

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.

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.

Position is open to candidates nationwide and is a fully remote role however you must be available to work Monday through Friday 8AM -5PM in CST.

Primary Responsibilities :

Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (MCG / 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.

Required Qualifications :

A current and unrestricted Compact RN license.

3+ years of clinical nursing experience practicing clinically (Acute Inpatient, SNF / AIR / LTAC, Emergency Department)

1+ years of experience with utilization review and evidence-based guidelines (MCG, InterQual Guidelines)

Demonstrate a proficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platforms

Has a designated workspace and access to install secure high-speed internet via cable / DSL in home

Preferred Qualifications :

A Bachelor's degree

Certification in Case Management (CCM)

2+ years case management / utilization review experience

Managed Care experience

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

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D. C. 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.

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.-

Compensation Information :

$114300.0 / Yearly - $114300.0 / Yearly

Starting At : 114300.0 Yearly

Up To : 0.0 Yearly