Inpatient Care Management Nurse RN - Remote

Optum; Phoenix (AZ); Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group seeks an Inpatient Care Management Nurse RN for a remote role across the U.S. The position focuses on reviewing inpatient cases, coordinating plans of care, and collaborating with medical directors to ensure appropriate utilization and discharge planning.

Strong nursing experience and solid software proficiency are required. The role offers telecommuting flexibility within Pacific, Mountain, or Central Time Zones and a comprehensive benefits package.

Qualifications

• Current, unrestricted RN license in state of residence.
• 3+ years of clinical nursing experience in acute inpatient, SNF/AIR/LTAC, ED, urgent care, doctor’s office or school nurse.
• Experience in acute, long term care or skilled nursing facilities.
• Proficiency with Windows, IM, Excel (Microsoft Suite) and Outlook; access to a secure home internet connection.
• Designated workspace with reliable internet for telecommuting.

Responsibilities

• Perform initial and concurrent review of inpatient cases using evidenced-based criteria (MCG/InterQual).
• Discuss cases with facility healthcare professionals to obtain plans of care.
• Collaborate with Medical Directors on utilization management.
• Contribute to care progression discussions to ensure appropriate levels of care.
• Recommend referrals to downstream partners for complex cases.
• Communicate with internal/external Case Managers and Physicians.
• Identify delays in care and work with MD to address them.
• Follow procedures for end-to-end case management and discharge planning.
• Gather clinical information to assess alternate levels of care.
• Participate in team meetings and audit activities.

Skills

RN license

Clinical nursing

Independent work

Verbal/written communication

Tools

Windows

IM

Excel

Outlook

Job description

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

Job Description - Inpatient Care Management Nurse RN - Remote (2388276)

Inpatient Care Management Nurse RN - Remote - 2388276

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.

As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization.

What makes your nursing career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

You’ll enjoy the flexibility to work remote * from the Pacific, Mountain, or Central Time Zone regions within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (i.e. MCG/Interqual criteria)
• Discuss cases with facility healthcare professionals to obtain plans-of-care
• Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management
• Participation in discussions with the Clinical Services team to improve the progression of care to the most appropriate level
• Consult with the Medical Director, as needed, for complex cases and make appropriate referrals to downstream partners
• Apply clinical expertise when discussing case with internal and external Case Managers and Physicians
• Identify delays in care or services and manage with MD
• Follow all Standard Operating Procedures in end to end management of cases
• Obtain clinical information to assess and expedite alternate levels of care
• Facilitate timely and appropriate care and effective discharge planning
• Participate in team meetings, education, discussions, and related activities
• Maintain compliance with Federal, State and accreditation organizations
• Identify opportunities for improved communication or processes
• Participate in audit activities and meetings

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 license in state of Residence
• 3+ years of clinical nursing experience practicing clinically (Acute Inpatient, SNF/AIR/LTAC, Emergency Department, Urgent Care, Doctor’s Office, School Nurse)

Experience in acute, long term care, acute rehabilitation, or skilled nursing facilities

• Proficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platforms
• Designated workspace and access to install secure high-speed internet via cable/DSL in home

Preferred Qualifications:

• Compact license
• Managed Care experience
• 1+ years of experience involving utilization review and evidence-based guidelines (i.e. MCG, InterQual Guidelines)
• Ability to work independently
• Demonstrated effective verbal and written communication skills

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

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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

UnitedHealth Group is 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 is 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.