UnitedHealth Group Inc.-posted 25 days ago
Full-time • Mid Level
Remote • Pearland, TX
5,001-10,000 employees
Insurance Carriers and Related Activities

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. The Concurrent Review Case Manager is responsible for telephonic monitoring and the documentation of medical treatment and comparing it to established criteria to determine if treatment meets established guidelines. In addition, the Concurrent Review Case Manager monitors patients progress toward recovery for early identification of continuing care needs in an attempt to facilitate discharge for specified populations. This position works closely with Medical Management Physician leadership and various internal departments You'll enjoy the flexibility to work remotely from anywhere within the U.S. 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.

  • telephonic monitoring
  • documentation of medical treatment
  • comparing treatment to established criteria to determine if treatment meets established guidelines
  • monitors patients progress toward recovery for early identification of continuing care needs in an attempt to facilitate discharge for specified populations
  • works closely with Medical Management Physician leadership and various internal departments
  • Associate Degree in Nursing or higher
  • Texas RN License
  • 5+ years of nursing experience in concurrent review
  • Managed Care knowledge
  • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
  • Certification in area of specialization, BSN
  • ACP certification
  • Case Management Certification
  • 2+ years in area of specialization, 2+ years of Case Management/Utilization Review experience
  • Proven program development skills
  • Proven communication and problem-solving skills; Computer literate
  • comprehensive benefits package
  • incentive and recognition programs
  • equity stock purchase
  • 401k contribution
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