LVN, QI Nurse - Remote

UnitedHealth Group; El Segundo (CA); Remote; Confidential; Full time

Job summary

UnitedHealth Group seeks an LVN, QI Nurse to join their team in California. This role involves reviewing member grievances and ensuring quality care. The successful candidate will enjoy the flexibility of remote work while contributing to vital healthcare improvements for the community.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Qualifications

• 2+ years of Clinical Nursing experience in an acute inpatient setting.
• Grievance and/or Quality Improvement experience.

Responsibilities

• Reviews health plan grievances and assigns severity levels.
• Creates documentation of quality-of-care findings.
• Prepares cases for peer review committee.

Skills

Clinical assessment skills

Education

Current LVN license in California

Job description

Optum CA is seeking a LVN, QI Nurse to join our team. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.

At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

If you are licensed in California and willing to work Pacific Standard time, you’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

As the Clinical Grievances Nurse, you will be responsible for reviewing incoming member cases to determine if the appropriate care was given.

Primary Responsibilities:

• Reviews health plan grievances and assigns an appropriate severity level and issue code.
• Create written documentation of quality-of-care findings, using effective clinical writing skills (e.g., inquiry letters, case summaries)
• and upload into applicable system
• Prepares cases for peer review committee
• Coordinates case reviews with the QI coordinator

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 LVN license in the state of California
• 2+ years of Clinical Nursing experience in an acute inpatient setting
• Grievance and or Quality Improvement experience
• Solid clinical assessment skills

Preferred Qualifications:

• Previous Inpatient Case Management experience
• Managed Care work experience

The hourly range for this role is $23.70 to $46.35 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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.

OptumCare 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.