NICU Utilization Management Nurse RN - Remote in Texas or Missouri

Optum • Schaumburg, IL

399d • Remote

About The Position

As a NICU Utilization Management Nurse at UnitedHealth Group, you will play a crucial role in ensuring that health services are administered efficiently and effectively. This position involves assessing and interpreting member needs, identifying solutions to enhance health outcomes, and providing support to both members and colleagues. The role is fully remote, requiring a current and unrestricted Compact RN License, and involves a commitment to work 40 hours per week with some flexibility, including working every other Saturday.

Requirements

• Current, unrestricted compact RN license required in the state of residence
• 3+ years of NICU Clinical experience
• Proven ability to demonstrate a proficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, and clinical platforms
• Willing to work weekends and holidays on rotation
• Designated workspace and access to high-speed internet via cable/DSL in home
• Permanent residence in the state of Texas or the state of Missouri
• Ability to work at least every other Saturday on a rotational basis

Nice To Haves

• Certified Case Manager (CCM)
• Utilization Management experience
• Case Management experience
• Knowledge of InterQual Criteria

Responsibilities

• Determine the appropriateness of inpatient services following evaluation of medical guidelines and benefit determination
• Identify solutions to non-standard requests and problems
• Translate concepts into practice
• Act as a resource for others; provide explanations and information on difficult issues

Benefits

• Comprehensive benefits
• Career development opportunities
• Flexibility to work remotely

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: No Education Listed