Preservice Review RN - VA Market Only - Remote - 2282600

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

Job summary

An established industry player is seeking dedicated nursing professionals to enhance the healthcare experience. This role offers the chance to work collaboratively with a team, focusing on patient care and communication with healthcare providers. With the flexibility to work remotely in Virginia, you will engage in critical case reviews and support patient care plans. Join a mission-driven organization committed to improving health outcomes and addressing disparities in care. This is an opportunity to make a significant impact in the healthcare system while enjoying a supportive work environment.

Benefits

Comprehensive benefits

Incentive and recognition programs

Stock purchase options

401(k) contributions

Qualifications

• Active RN license in Virginia is required for this role.
• 3+ years of experience in an acute care setting is essential.

Responsibilities

• Review HCBS authorizations using Virginia-specific criteria.
• Consult with Care Manager and Medical Director for complex cases.

Skills

Active RN license in VA

3+ years of RN experience in an acute setting

Proficiency in Microsoft Word

Proficiency in Windows environment

Proficiency in Outlook

Internet searches

Tools

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. Join us to build a more responsive, affordable, and equitable health care system. 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, ensuring members receive proper health services. Maintaining communication with care facilities to support patients' care plans is essential. 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 a collaborative team culture that is learning and evolving daily. Contributing here opens unique opportunities that are unmatched elsewhere.

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

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 for complex cases

Performance recognition and development opportunities are integral to our environment, challenging you to succeed and grow in your role.

Required Qualifications:

• Active RN license in VA
• 3+ years of RN experience in an acute setting
• Proficiency in Microsoft Word, Windows environment, Outlook, and internet searches

Preferred Qualifications:

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

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

The hourly range for this role is $28.61 to $56.06, based on full-time employment and various factors such as location, experience, and certifications. We offer comprehensive benefits, incentive and recognition programs, stock purchase options, and 401(k) contributions. Join us to access a broad array of benefits and opportunities.

Our mission is to help people live healthier lives and improve the health system for everyone. We are committed to addressing health disparities and promoting equitable care, reflecting our enterprise priorities.

UnitedHealth Group is an Equal Employment Opportunity employer. Qualified applicants will be considered without regard to race, national origin, religion, age, gender, sexual orientation, gender identity, disability, veteran status, or other protected characteristics. We are a drug-free workplace requiring a pre-employment drug test.