Remote RN Care Navigator

Jobtome; Denver (CO); Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealthcare is seeking a registered nurse to join a frontline care management program that educates and supports members across the continuum of care. This role blends nursing expertise with customer service to guide members toward better health outcomes.

The position allows full-time remote work from anywhere in the United States, with Monday–Friday 8:00 am–5:00 pm scheduling; requires nursing licensure, 4+ years acute care, and 2+ years case management.

Qualifications

• Current and unrestricted RN compact license.
• 4+ years of acute nursing experience as an RN.
• 2+ years of case management experience.
• Med-surg, critical care and/or ER experience.
• Proven ability to function independently with minimal supervision.
• Basic computer proficiency (ie MS Word, Outlook)

Responsibilities

• Acts as resource to members calling into a customer service setting addressing medical/health questions
• Own problem through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member
• Provide process and status on previously submitted prior authorizations or pre-determination requests
• Effectively refers and enrolls members to appropriate internal specialists and programs, based on member's needs and eligibility
• Support and advocate for members and families in complicated medical situations
• Use good nursing judgement in a variety of scenarios real time
• Accurately documents member interaction across multiple databases, while on the call and appropriate follow all processes and procedures
• Educates members in healthcare decision making
• Takes lead role in setting direction and participating in or developing new program and initiatives to improve performance of new program
• Ability to collaborate with peers and managers to improve service model performance
• Assists with the development and implementation of departmental policies and procedures
• Enjoys working in a fast paced environment and must be able to adapt quickly to change while executing efficiently

Skills

RN experience

Case management experience

Customer service oriented

Nursing judgement

Education

RN license

Tools

MS Word

Outlook

Job description

UnitedHealthcare is seeking a registered nurse to join a frontline care management program that educates and supports members across the continuum of care. This role blends nursing expertise with customer service to guide members toward better health outcomes.

The position allows full-time remote work from anywhere in the United States, with Monday–Friday 8:00 am–5:00 pm scheduling; requires nursing licensure, 4+ years acute care, and 2+ years case management.