Inpatient Care Management RN - Impactful Utilization Review

UnitedHealth Group; Alabama; Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group in Mobile, AL is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services by assessing member needs and identifying care solutions that keep patients healthy.

You will perform initial and concurrent reviews using InterQual criteria, collaborate with facility staff and Medical Directors, and support timely discharge planning while upholding SOPs and quality standards. Residence in Eastern or Central Time is required.

Qualifications

• Active, unrestricted RN license in state of residence.
• 1+ years recent clinical nursing experience in an Acute Inpatient Hospital setting.
• 1+ years of Utilization Review experience using InterQual Guidelines, in hospital or health insurance.
• Designated workspace and access to secure high-speed internet at home.
• Permanent residence in Eastern or Central Time Zone.

Responsibilities

• Perform initial and concurrent review of inpatient cases applying InterQual criteria.
• Discuss cases with facility healthcare professionals to obtain plans-of-care.
• Collaborate with Medical Directors on utilization management.
• Support progression of care to appropriate levels and discharge planning.

Skills

Inpatient nursing

Utilization Review

Clinical collaboration

Education

RN license

Tools

InterQual Guidelines

Job description

UnitedHealth Group in Mobile, AL is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services by assessing member needs and identifying care solutions that keep patients healthy.

You will perform initial and concurrent reviews using InterQual criteria, collaborate with facility staff and Medical Directors, and support timely discharge planning while upholding SOPs and quality standards. Residence in Eastern or Central Time is required.