Inpatient Authorization RN - Central Time Zone

UnitedHealth Group•New Orleans, LA

3d•Remote

About The Position

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Authorization Nurse is responsible for engaging in the collaborative process which assesses, plans, implements, coordinates, monitors and evaluates services to help improve member’s health outcomes. If you have your RN License in the state of LA, or a Compact License from any state in the Central Time Zone you will have the flexibility to work remotely as you take on some tough challenges. 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.

Requirements

Current/Active Louisiana Registered Nurse (RN) or Compact License from any state in Central Time Zone
Experience in a clinic/hospital or similar setting
Experience with clinical documentation systems
Experience in assessing members and developing care plans
Computer/typing proficiency to enter/retrieve data in electronic clinical records and documentation systems, experience with email, internet research, use of online calendars and other software applications

Nice To Haves

Bachelor of Nursing
3+ years of clinical experience in health care and/or managed care
Experience with medical terminology and coding
Working knowledge in Interqual and CMS guidelines
Understanding of healthcare industry
Understanding of nursing home, skilled nursing facility and long-term acute care regulations
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

Review and documentation of requests for services via electronic transmittal and/or fax for inpatient services
Processes the initial review for all hospitalized members within assigned facilities
Collaborates with the interdisciplinary care team (ICT) and medical director(s) to facilitate appropriate treatment for members and identify high risk members that will be followed by the care coordinators
Initiates care coordination (Nurse Practitioner, MSW, RN) referrals for members when necessary
Monitors the member’s adherence to the plan of care
Collaborates with the hospital case management staff and facility care providers to review admission and discharge planning
When appropriate, involves and assists member and/or caregiver in continuation of care to the outpatient setting or alternative levels of care