Remote RN Care Navigator & Member Educator

Palo Verde Community College District; Phoenix, Northern (AZ, KY); Hybrid; USD 60,000 - 107,000; Full time

Job summary

UnitedHealthcare is seeking a registered nurse to provide guidance and education to members as a frontline clinical resource. The role centers on helping members navigate care, educate on health decisions and coordinate with internal specialists to meet needs.

The position requires a valid RN license and 4+ years of acute nursing experience, plus 2+ years in case management. It is remote in the U.S. with CPT-friendly, customer-service oriented responsibilities and ongoing policy adherence.

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 (ie MS Word, Outlook).
• Proven ability to function independently 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 follow-up.
• Provide process and status on previously submitted prior authorizations or pre-determination requests.
• Effectively refers and enrolls members to appropriate internal specialists and programs.
• Support and advocate for members and families in complicated medical situations.
• Use nursing judgement in a variety of scenarios real time.

Skills

RN license

Acute nursing experience

Case management experience

Med-surg/ICU/ER experience

Computer proficiency

Independent worker

Education

Bachelor's degree in nursing

CCM

Tools

MS Word

Outlook

Job description

UnitedHealthcare is seeking a registered nurse to provide guidance and education to members as a frontline clinical resource. The role centers on helping members navigate care, educate on health decisions and coordinate with internal specialists to meet needs.

The position requires a valid RN license and 4+ years of acute nursing experience, plus 2+ years in case management. It is remote in the U.S. with CPT-friendly, customer-service oriented responsibilities and ongoing policy adherence.