SSBV Clinical Claim Review RN

UnitedHealth Group • Plymouth, MN

6d • Remote

About The Position

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 resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Let's face it, no industry is moving faster than health care. And no organization is better positioned to lead health care forward than UnitedHealthcare, part of the UnitedHealth Group family of businesses. As a SSBV Clinical Claims Review RN, you can put your skills and talents to work. This is a multifaceted role that is highly rewarding.
It feels great to have autonomy, though there's also a lot of responsibility that comes with it. In this role, you'll be accountable for making decisions that directly impact on our members. And at the same time, you'll be challenged by a demanding case load in a rapidly changing, production-driven environment.
You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Requirements

• Associate's degree
• Current and unrestricted RN license in the state of residency
• 5+ years of clinical documentation experience
• 3+ years of experience as an RN, including inpatient/acute setting
• Intermediate level of proficiency in Microsoft Office (to include Microsoft Excel and One Note)
• Intermediate level of proficiency in writing
• Designated home office workspace with access to install secure high-speed internet via cable/DSL

Nice To Haves

• Undergraduate or higher degree
• A background in utilization review for an insurance company or experience in case management
• Familiarity with InterQual and/or MCG Care Guidelines
• Critical thinking skills

Responsibilities

• Perform administrative reviews of short stay inpatient hospital claims in accordance with Federal, State and client specific requirements
• Responsible for documentation of all determinations
• Maintain accurate use of screening criteria

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree