Preservice Review Nurse RN - Remote

UnitedHealth Group; Oklahoma; Remote; USD 40.000 - 72.000; Vollzeit

Benefits dieser Stelle

Benefits package

Incentives and recognition

Equity stock purchase & 401k

Zusammenfassung

UnitedHealth Group is seeking a Preservice Review Nurse RN to perform clinical coverage reviews and interpret state and federal mandates while working remotely from Tulsa, OK. The role emphasizes strong documentation and clear communication of benefit determinations to providers and members.

The position requires 2+ years of RN experience, inpatient/acute care exposure, and a current Oklahoma RN license, with a compact license preferred.

Qualifikationen

• 2+ years of RN experience, including experience in an inpatient/acute setting.
• Professional experience in direct patient care.
• Background involving utilization review for an insurance company or experience in case management preferred.

Aufgaben

• Perform clinical coverage review services, interpreting state and federal mandates and applicable benefit language.
• Function as a member of a self-directed team to meet specific individual and team performance metrics.
• Communicate in writing and verbally all types of benefit determinations, including decisions regarding coverage guidelines.
• Engage in telephonic discussions with healthcare providers and/or members to explain benefit coverage determinations and obtain additional clinical information.
• Act as a resource for others with less experience.
• Work independently while collaborating with Medical Directors and non-clinical partners.
• Adapt to a highly changing environment and manage a heavy case load.

Kenntnisse

RN experience

Clinical documentation

Communication skills

Ausbildung

Bachelor's degree

Jobbeschreibung

About This Role

The Preservice Review Nurse RN will perform clinical coverage review services, interpreting state and federal mandates while working remotely. This role is ideal for nurses with strong clinical documentation skills and the ability to communicate effectively.

Highlights

• Pay: $29 - $52/hour
• Location: Tulsa, OK
• Department/Unit: Remote
• Schedule: Full Time, Day shift
• Residency: Must reside in Oklahoma

What You'll Do

• Perform clinical coverage review services, interpreting state and federal mandates and applicable benefit language.
• Function as a member of a self-directed team to meet specific individual and team performance metrics.
• Communicate in writing and verbally all types of benefit determinations, including decisions regarding coverage guidelines.
• Engage in telephonic discussions with healthcare providers and/or members to explain benefit coverage determinations and obtain additional clinical information.
• Act as a resource for others with less experience.
• Work independently while collaborating with Medical Directors and non-clinical partners.
• Adapt to a highly changing environment and manage a heavy case load.

Requirements

Education: Bachelor's degree preferred

Experience:

• 2+ years of RN experience, including experience in an inpatient/acute setting
• Professional experience in direct patient care
• Background involving utilization review for an insurance company or experience in case management preferred

Licenses & Certifications:

• Current unrestricted RN license in Oklahoma required
• Compact RN license preferred

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase and 401k contribution

About UnitedHealth Group

UnitedHealth Group is a leading healthcare provider committed to delivering exceptional patient care. They harness technology and innovation to make healthcare simpler, more affordable, and more connected for the people they serve. The organization values diversity and inclusion, empowering employees to bring their authentic selves to work.