Preservice Review RN - VA Market Only - Remote

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

Job summary

Join a leading healthcare company to provide high-quality care and support patients through their health plans. This role offers the chance to work remotely while collaborating with healthcare professionals to ensure proper health services are delivered. Enjoy a culture that fosters growth and development, with opportunities to advance your nursing career.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Stock purchase options

401(k) contributions

Qualifications

• 3+ years of RN experience in an acute setting.
• Unrestricted, active RN license in Virginia.

Responsibilities

• Authorization review and entry for HCBS authorizations.
• Communication with HCBS Providers.
• Gather clinical information to assess care needs.

Skills

Communication

Clinical Assessment

Problem Solving

Education

RN License in VA

Tools

Microsoft Word

Microsoft Outlook

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. Join us to build the health care system of tomorrow—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 role offers the opportunity to provide a higher level of care and shape how health care services are delivered. You will discuss cases with treating physicians and healthcare professionals to ensure our members receive proper health services. Maintaining communication with acute long-term care, rehabilitation, or skilled nursing facilities is essential to support patients through their care plans. Join us—this could be the start of your life's best work.

What makes your nursing career greater with UnitedHealth Group? You can improve others' health and help heal the health care system. Work within an incredible team culture that fosters clinical and business collaboration, learning, and evolving daily. Contributing here opens doors that are unavailable elsewhere.

If you reside in Virginia, you’ll enjoy the flexibility to work remotely while tackling challenging issues.

Primary Responsibilities:

1. Authorization review and entry for HCBS authorizations using Virginia-specific criteria
2. Review of state-specific documents required for HCBS services
3. Communication with HCBS Providers
4. Gather clinical information to assess and expedite care needs
5. 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 challenges you and provides clear success pathways, as well as development opportunities for other roles you may pursue.

Required Qualifications:

• Unrestricted, active RN license in VA
• 3+ years of RN experience in an acute setting
• Ability to create, edit, save, and send documents using Microsoft Word
• Proficiency in navigating a Windows environment, Microsoft Outlook, and conducting Internet searches

Preferred Qualifications:

• HCBS authorization experience
• Utilization management, prior authorization, and case management experience
• Managed care experience
• Knowledge of ICUE and CAT Launchpad

*All remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.

The hourly pay range is $28.61 to $56.06, based on full-time employment and factors like location, education, experience, and certifications. UnitedHealth Group complies with all applicable minimum wage laws. Benefits include comprehensive packages, incentive and recognition programs, stock purchase options, and 401(k) contributions, subject to eligibility. Starting a career here offers extensive benefits and growth opportunities.

Our mission is to help people live healthier lives and improve the health system for everyone, regardless of race, gender, sexuality, age, income, or background. We are committed to reducing health disparities and promoting equitable care, reflecting our enterprise priorities.

UnitedHealth Group is an Equal Employment Opportunity employer. Qualified applicants will receive consideration without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, veteran status, or other protected characteristics. We are a drug-free workplace; candidates must pass a drug test before employment.