Remote RN Case Manager & Member Care Advocate

UHC; Bellevue (WA); Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Remote work

Benefits package

Job summary

UnitedHealthcare is seeking an experienced registered nurse to join a new program delivering guidance and education to members across the continuum of care. This frontline clinical role emphasizes education, care coordination, and customer service to improve health outcomes.

The position offers broad flexibility, with remote work from anywhere in the U.S. and a Monday–Friday schedule supporting members and internal teams from a central program office.

Qualifications

• Current and unrestricted RN license (compact)
• 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 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

acute nursing experience

case management experience

Med-surg/ICU/ER experience

basic computer proficiency

independence with minimal supervision

Education

Bachelor's degree in nursing

Job description

UnitedHealthcare is seeking an experienced registered nurse to join a new program delivering guidance and education to members across the continuum of care. This frontline clinical role emphasizes education, care coordination, and customer service to improve health outcomes.

The position offers broad flexibility, with remote work from anywhere in the U.S. and a Monday–Friday schedule supporting members and internal teams from a central program office.