Preservice Review RN - Remote in VA Market Only

UnitedHealth Group; Richmond (VA); Hybrid; Confidential; Full time

Job summary

An established industry player is seeking a dedicated Registered Nurse to join their team in Virginia. This role offers the chance to influence the health care system positively by ensuring patients receive the necessary services. You'll collaborate with healthcare professionals, manage authorizations, and contribute to a supportive team culture. With flexibility to work remotely, this position allows you to tackle challenges while improving the health of others. Join a mission-driven organization committed to equitable care and making a real difference in the community.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Qualifications

• Active RN license required, with 3+ years experience in acute settings.
• Proficiency in Microsoft Word and Outlook is essential.

Responsibilities

• Review HCBS authorizations and state documents for services.
• Communicate with HCBS providers and gather clinical information.

Skills

Registered Nurse (RN)

Communication Skills

Clinical Assessment

Microsoft Word

Microsoft Outlook

Internet Navigation

Education

Unrestricted RN License

3+ years RN experience

Tools

Windows Environment

ICUE

CAT Launchpad

Job description

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

Are you ready for your next challenge? Discover it here at UnitedHealthcare and help us reinvent the health system. This can be your opportunity to take on a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. You will discuss cases with treating physicians and other healthcare professionals to ensure our members receive the proper health services. You will be required to maintain communication with acute long-term care, acute rehabilitation, or skilled nursing facilities in order to help patients through their care plan. This is an exciting opportunity at a truly inspired organization. Join us. This can be the start of your life's best work.

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.

If you reside within the state of Virginia, you’ll enjoy the flexibility to work remotely as you take on some tough challenges.

Primary Responsibilities:

• Authorization review and entry for HCBS authorizations using Virginia specific criteria
• Review of state specific documents required for HCBS services
• Communication with HCBS Providers
• Gather clinical information to assess and expedite care needs
• Consult with the Care Manager and/or Medical Director as needed to troubleshoot difficult or complex cases

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:

• Unrestricted, active RN license
• 3+ years of RN experience in an acute setting
• Ability to create, edit, save and send documents utilizing Microsoft Word
• Ability to navigate a Windows environment, Microsoft Outlook, and conduct Internet searches

Preferred Qualifications:

• HCBS authorization experience
• Utilization management, prior authorization, and case management experience
• Working knowledge of ICUE and CAT Launchpad
• Previous managed care experience a plus

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

The hourly range for this role is $28.61 to $56.06 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 all 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).

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.

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.