Remote Inpatient Care Manager RN — Elevate Utilization & Care

NHSHP; Phoenix, Northern (AZ, KY); Hybrid; USD 60,000 - 107,000; Full time

Benefits offered by this job

Telecommuter Policy

Benefits package

401k contribution

Equity stock purchase

Job summary

UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services. You will assess member needs, interpret requirements, and collaborate with healthcare professionals to plan care and discharge efficiently.

You will work remotely within the Pacific, Mountain, or Central Time Zone regions, joining a team focused on improving care progression and compliance with standards while supporting education and audits.

Qualifications

• Current, unrestricted RN license in state of Residence.
• 3+ years of clinical nursing experience practicing clinically (Acute Inpatient, SNF/AIR/LTAC, Emergency Department, Urgent Care, Doctor's Office, School Nurse).
• Experience in acute, long term care, acute rehabilitation, or skilled nursing facilities.
• Proficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platforms.
• Designated workspace and access to install secure high-speed internet via cable/DSL in home.

Responsibilities

• Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (MCG/Interqual).
• Discuss cases with facility healthcare professionals to obtain plans-of-care.
• Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management.
• Contribute to discussions with Clinical Services to improve progression of care to the most appropriate level.
• Consult with Medical Director for complex cases and referrals to downstream partners.
• Apply clinical expertise when discussing cases with internal/external Case Managers and Physicians.
• Identify delays in care or services and coordinate with MD.
• Follow SOPs in end-to-end management of cases.
• Obtain clinical information to assess and expedite alternate levels of care.
• Facilitate timely and appropriate care and discharge planning.
• Participate in team meetings, education, discussions, and related activities.
• Maintain compliance with Federal, State and accreditation organizations.
• Identify opportunities for improved communication or processes.
• Participate in audit activities and meetings.

Skills

Windows

IM

Excel

Outlook

Clinical platforms

Education

Bachelor's degree

Tools

RN license

Job description

UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services. You will assess member needs, interpret requirements, and collaborate with healthcare professionals to plan care and discharge efficiently.

You will work remotely within the Pacific, Mountain, or Central Time Zone regions, joining a team focused on improving care progression and compliance with standards while supporting education and audits.