Remote RN Care Navigator & Member Education Lead

UHC; Glendale (AZ); Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealthcare is hiring an experienced registered nurse to guide and educate members across the continuum of care, acting as a frontline clinical resource in a customer-service oriented setting.

This remote role supports members nationwide, with Monday–Friday 8:00 am–5:00 pm availability. The compensation band is $60,200–$107,400 annually, plus a comprehensive benefits package, and telecommuting is allowed.

Qualifications

• Current and unrestricted RN license.
• 4+ years of acute nursing experience.
• 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 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.

Skills

RN license

Case management

Nursing experience

Communication skills

MS Word/Outlook

Education

Bachelor's degree in nursing

CCM certification

Job description

UnitedHealthcare is hiring an experienced registered nurse to guide and educate members across the continuum of care, acting as a frontline clinical resource in a customer-service oriented setting.

This remote role supports members nationwide, with Monday–Friday 8:00 am–5:00 pm availability. The compensation band is $60,200–$107,400 annually, plus a comprehensive benefits package, and telecommuting is allowed.