Remote RN Clinical Care Navigator

Jobtome; Papillion (NE); Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealthcare is seeking a registered nurse to guide and educate members across the continuum of care. This frontline clinical resource role emphasizes education, support, and customer service. Work remotely from anywhere in the U.S.

Monday–Friday 8:00 am–5:00 pm. Responsibilities include nursing guidance, authorizations handling, referrals, and collaboration to improve service models. Requirements include an RN license, 4+ years of acute nursing, 2+ years case management, Med-surg/ICU/ER

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).
• Ability to work independently with minimal supervision.
• Preferred: Bachelor's degree in nursing and CCM or managed care experience.
• Preferred: Telecommute experience.

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 with timely follow-up.
• Provide process and status on previously submitted prior authorizations or pre-determination requests.
• Refer and enroll members to internal specialists and programs based on needs.
• Support and advocate for members and families in complicated medical situations.
• Use nursing judgement in diverse scenarios in real time.
• Document member interactions across multiple databases during and after calls.
• Educate members in healthcare decision making.
• Lead in setting direction and developing new programs to improve performance.
• Collaborate with peers and managers to improve service model performance.
• Assist with development and implementation of departmental policies.
• Adapt quickly to change while delivering efficient results.

Skills

Verbal communication

Customer service

Team player

Adaptability

Education

RN license (compact)

Bachelor's degree in nursing

Tools

MS Word

Outlook

Job description

UnitedHealthcare is seeking a registered nurse to guide and educate members across the continuum of care. This frontline clinical resource role emphasizes education, support, and customer service. Work remotely from anywhere in the U.S.

Monday–Friday 8:00 am–5:00 pm. Responsibilities include nursing guidance, authorizations handling, referrals, and collaboration to improve service models. Requirements include an RN license, 4+ years of acute nursing, 2+ years case management, Med-surg/ICU/ER