Remote RN Care Navigator & Care Coordination

ISHE; Boise, Northern (ID, KY); Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Remote work

Job summary

UnitedHealthcare is seeking a Senior Clinical Admin Nurse to provide individualized support to UMR members and families, aiding navigation of the health care system and coordination with clinical teams. This role emphasizes independence, strong communication, and collaboration with partners, with remote work across the U.S.

Primary responsibilities include counseling on admission and discharge, assisting with appeals, and documenting activities for reporting.

Qualifications

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

Responsibilities

• Provide members with tools and educational support to navigate the health care system and manage health concerns effectively and cost efficiently.
• Assist members with adverse determinations, including the appeal process.
• Teach members how to navigate UMR internet-based wellness tools and resources.
• Outreach to membership providing pre-admission counseling to membership.
• Outreach to membership providing discharge planning to membership and caretakers.
• Track all activities and provide complete documentation for customer reporting.
• Accept referrals via designated processes, collaborate in evaluating services, and coordinate medical care and community referrals.

Skills

Communication skills

Customer service

Team player

Adaptability

Education

RN license (compact) or equivalent

Tools

MS Word

Outlook

Job description

UnitedHealthcare is seeking a Senior Clinical Admin Nurse to provide individualized support to UMR members and families, aiding navigation of the health care system and coordination with clinical teams. This role emphasizes independence, strong communication, and collaboration with partners, with remote work across the U.S.

Primary responsibilities include counseling on admission and discharge, assisting with appeals, and documenting activities for reporting.