Utilization Management Nurse RN - Remote MST Hours
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. If you have the ability to work MST Hours, you will have the flexibility to work remotely as you take on some tough challenges. 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'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.
Requirements
- Unrestricted RN license in state of residence
- 3+ years of Managed Care and/or Clinical experience
- MS Office including Excel, Word, and OneNote
- Experience working with multiple EMRs (electronic medical records)
Nice To Haves
- Utilization Management experience
- Knowledge of Milliman Criteria
- All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Responsibilities
- Determine the appropriateness of inpatient and 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
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Insurance Carriers and Related Activities
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
