Remote Inpatient Care Manager RN — Impactful Utilization

IntelliResume; Arizona; Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock plan

401k

Job summary

UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services by assessing member needs and coordinating care.

Based in Phoenix, AZ with a fully remote work style, the role requires 3+ years of clinical nursing in acute settings and an active RN license. You will perform reviews using criteria (MCG/InterQual), collaborate with physicians and case managers, and support timely discharge planning.

Qualifications

• 3+ years of clinical nursing experience in acute inpatient or equivalent.
• Experience in acute, long-term care, rehabilitation, or skilled nursing facilities.
• Current, unrestricted RN license in the state of residence.

Responsibilities

• Perform initial and concurrent review of inpatient cases using evidence-based criteria (MCG/Interqual).
• Discuss cases with facility healthcare professionals to obtain plans of care.
• Collaborate with Optum Enterprise Clinical Services Medical Directors on utilization management.
• Participate in discussions with the Clinical Services team to improve progression of care to the most appropriate level.
• Consult with the Medical Director for complex cases and make referrals to downstream partners.
• Apply clinical expertise when discussing cases with internal and external Case Managers and Physicians.
• Identify delays in care or services and manage with MD.
• Follow all 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 effective discharge planning.

Education

RN license

Job description

UnitedHealth Group is seeking an Inpatient Care Management Nurse to ensure proper utilization of health services by assessing member needs and coordinating care.

Based in Phoenix, AZ with a fully remote work style, the role requires 3+ years of clinical nursing in acute settings and an active RN license. You will perform reviews using criteria (MCG/InterQual), collaborate with physicians and case managers, and support timely discharge planning.