Quality Assurance Nurse

UnitedHealth Group • Grand Junction, CO

238d • $59,500 - $116,600 • 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 Quality Assurance Nurse is responsible for supporting corporate objectives and ensures quality health care by providing oversight of appeals and quality of care issues. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

• Current and unrestricted RN license
• 5+ years of clinical nursing experience
• 2+ years of behavioral health experience
• Experience facilitating presentations
• Intermediate computer skills (Microsoft Word, Excel, Outlook, and Internet) with the ability to navigate a Windows environment
• Ability to work Monday - Friday 8:00 am - 5:00 pm MST

Nice To Haves

• RN license in the state of Colorado
• Previous managed care experience
• Experience working with providers
• Demonstrated ability to manage multiple projects simultaneously

Responsibilities

• Work collaboratively with the Chief Medical Officer, Appeals & Grievance Team, Associate Medical Directors and others as necessary to ensure the integrity of medical and clinical decisions
• Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees
• Ability to work with minimal guidance; seeks guidance on only the most complex tasks
• Provides input in physical health and behavioral health appeals
• Able to review complex information and summarize key points for appeals, indicating necessary review points for physician review
• Provides nursing input to quality assurance issues, particularly quality of care considerations
• Able to present investigations to internal teams to help decide leveling and action plans

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree