Fertility Utilization Management RN - Remote

Optum; Des Moines (IA); Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Remote work

Benefits package

401k contribution

Job summary

Optum is seeking a Fertility Utilization Management RN to work remotely within the United States. You will assess and determine the appropriateness of inpatient and outpatient services, translating clinical concepts into practical care-management decisions.

This role offers remote work from anywhere in the U.S. with CST hours 8a–5:30p, comprehensive benefits, and opportunities for growth within UnitedHealth Group.

Qualifications

• Current unrestricted RN licensure in residence state.
• Compact license and/or willingness to obtain licenses in CA, NV, NM, OK, WA, WY.
• 3+ years of Managed Care and/or Clinical experience.
• 1+ years of fertility experience.
• Proven computer proficiency and ability to navigate Windows.
• Willingness to work core hours 8a–5:30p CST.

Responsibilities

• Determine the appropriateness of inpatient and outpatient services.
• Identify solutions to non-standard requests and problems.
• Translate concepts into practice for care management.
• Serve as a resource and provide explanations on difficult issues.
• Operate in a self-directed, less structured environment.
• Collaborate on complex issues and support team members.

Skills

RN licensure

Compact license

Managed Care experience

Fertility experience

Windows proficiency

CST hours availability

Job description

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Fertility Utilization Management RN - Remote (2391691)

Fertility Utilization Management RN - Remote - 2391691

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.

Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Utilization Management Nurse at UnitedHealth Group, you will make sure our health services are administered efficiently and effectively. You'll assess and interpret member needs and identify solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready to make an impact?

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. The work schedule for this position is 8a - 5:30p Central Time, Monday - Friday.

Primary 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
• Generally, work is self-directed and not prescribed
• Works with less structured, more complex issues
• Serves as a resource to others
• 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.

Required Qualifications:

• Current unrestricted RN licensure in state of Residence
• Compact license and/or willingness to obtain additional licenses in the following states: CA, NV, NM, OK, WA and WY
• 3+ years of Managed Care and/or Clinical experience
• 1+ years of fertility experience
• Proven computer proficiency, to include strong data entry skills and the ability to navigate a Windows environment
• Willing or ability to work on core hours 8a - 5:30p CST

Preferred Qualifications:

• 3rd party reproduction knowledge
• Knowledge of Milliman Criteria

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.