Remote Inpatient Care Manager RN – Utilization

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

Job summary

UnitedHealth Group is seeking an Inpatient Care Management Nurse to assess member needs and identify solutions that help members live healthier lives. The role emphasizes utilization review using InterQual criteria and collaboration with facility staff to plan care in a fast-paced inpatient setting.

The position is full-time with a day shift and requires residency in EST or CST. The role is fully remote with a pay range of $60,200–$107,400 annually.

Qualifications

• Active, unrestricted RN license in state of residence.
• 1+ years of clinical nursing in an Acute Inpatient Hospital setting.
• 1+ years of Utilization Review using InterQual Guidelines.

Responsibilities

• Perform initial and concurrent review of inpatient cases applying InterQual criteria.
• Discuss cases with facility healthcare professionals to obtain plans of care.
• Collaborate with Medical Directors on utilization management.
• Support progression of care to the most appropriate level.
• Consult with physicians for complex cases and referrals.
• Apply clinical expertise when discussing cases with Case Managers and Physicians.
• Identify delays in care and drive expedited decisions with MDs.
• Follow SOPs for end-to-end case management.
• Obtain clinical information to assess alternate levels of care.
• Facilitate timely and appropriate care and discharge planning.

Skills

Nursing

Utilization Review

InterQual

Clinical assessment

Education

Active, unrestricted RN license

Tools

InterQual guidelines

Job description

UnitedHealth Group is seeking an Inpatient Care Management Nurse to assess member needs and identify solutions that help members live healthier lives. The role emphasizes utilization review using InterQual criteria and collaboration with facility staff to plan care in a fast-paced inpatient setting.

The position is full-time with a day shift and requires residency in EST or CST. The role is fully remote with a pay range of $60,200–$107,400 annually.