Utilization Management Nurse RN

UnitedHealth Group•Eden Prairie, MN

1d•$60,200 - $107,400•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. It feels great to have autonomy, and there's also a lot of responsibility that comes with it. In this role, you'll be accountable for making decisions that directly impact our members. And at the same time, you'll be challenged by leveraging technologies and resources 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
Unrestricted Registered Nurse License in your state of residence
3+ years of Managed Care and/or Clinical experience
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Candidates are required to pass a drug test before beginning employment.

Nice To Haves

Oncology experience
Pre-authorization experience
Utilization Management experience
Case Management experience
Knowledge of NCCN guidelines
Certified Case Manager (CCM)
Insurance policies experience

Responsibilities

Determine the appropriateness of outpatient 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