Remote RN Care Navigator & Member Educator

Texas Health Institute

Phoenix, Northern (AZ, KY)

Hybrid

USD 60,000 - 107,000

Full time

5 days ago

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Job summary

UnitedHealthcare is seeking an experienced Registered Nurse to join a new program delivering frontline clinical guidance and education to members. The role emphasizes customer service, nursing judgment, and collaboration with internal teams to improve service delivery.

The position requires an active RN license and 4+ years of acute nursing plus 2+ years in case management, with Med-surg/ICU/ER experience. Remote work is available nationwide, with standard business hours and weekend coverage as

Qualifications

Current and unrestricted RN 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).

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 timely follow-up.
Provide process and status on previously submitted prior authorizations or pre-determination requests.
Refer and enroll members to appropriate internal specialists and programs based on needs and eligibility.
Support and advocate for members and families in complicated medical situations.
Document member interactions across databases during calls and follow procedures.
Educate members in healthcare decision making.
Lead development of new programs and initiatives to improve performance.