Remote RN Care Navigator for Member Support

Anacalifornia; Phoenix (AZ); Hybrid; USD 60,000 - 107,000; Full time

Benefits offered by this job

Benefits package

Equity stock purchase program

401k contribution

Job summary

UnitedHealthcare is seeking a registered nurse to provide guidance and education to members across the continuum of care as a frontline clinical resource. This role focuses on health management education, with strong customer service orientation and nursing generalist background.

The position offers remote work within the United States, requires a Monday–Friday 8:00 am–5:00 pm schedule, and emphasizes collaboration to improve service model performance and program initiatives.

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.
• Basic computer proficiency (MS Word, Outlook).
• Proven ability to function independently and responsibly with minimal supervision.

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 license

Case management

Acute nursing

Communication

Customer service

Team player

Adaptability

Education

Bachelor's degree in nursing

Tools

MS Word

Outlook

Job description

UnitedHealthcare is seeking a registered nurse to provide guidance and education to members across the continuum of care as a frontline clinical resource. This role focuses on health management education, with strong customer service orientation and nursing generalist background.

The position offers remote work within the United States, requires a Monday–Friday 8:00 am–5:00 pm schedule, and emphasizes collaboration to improve service model performance and program initiatives.