Compact RN Utilization Management Nurse

UnitedHealth Group, Inc.; United States; Remote; USD 75,000 - 95,000; Full time

Job summary

A leading healthcare company is seeking a Utilization Management Nurse RN for a remote position. Responsibilities include conducting prior authorization reviews and evaluating medical appropriateness of care levels. The ideal candidate should have at least 3 years of hospital experience and a valid RN license, with the ability to work some weekends.

Qualifications

• Minimum of 3 years hospital experience (Med Surg, Telemetry, ICU).
• Ability to work standard business hours in the Pacific Time zone.
• Available to work weekends (Saturday or Sunday).

Responsibilities

• Conduct prior authorization reviews for skilled nursing facilities.
• Evaluate medical appropriateness of levels of care based on guidelines.
• Provide resources and solutions for complex, non-standard requests.

Skills

Nursing assessment

Critical thinking

Communication skills

Education

Active, unrestricted RN license

Tools

MS Outlook

MS Word

MS Excel

Job description

A company is looking for a Utilization Management Nurse RN - Remote.

Key Responsibilities

• Conduct prior authorization reviews for skilled nursing facilities, acute inpatient rehabilitation, and long-term acute care hospitals
• Evaluate medical appropriateness of levels of care based on guidelines and benefit determinations
• Provide resources and solutions for complex, non-standard requests and issues

Required Qualifications

• Active, unrestricted RN license in state of residency or Compact RN License
• 3+ years of hospital experience (e.g., Med Surg, Telemetry, ICU)
• Basic computer skills with MS Outlook, Word, and Excel
• Availability to work weekends (Saturday or Sunday)
• Ability to work standard business hours in the Pacific Time zone