Remote RN Clinical Navigator & Member Educator

ISHE; Phoenix, Northern (AZ, KY); Hybrid; USD 60,000 - 107,000; Full time

Benefits offered by this job

Benefits package

Equity stock purchase

401k contribution

Job summary

UnitedHealthcare is seeking an experienced registered nurse to build trusted relationships with members across care continuum, providing guidance and education as a front-line clinical resource. The role emphasizes customer service with nursing judgment in a fast-paced remote setting across the United States.

Requirements include an active RN license, 4+ years acute nursing, 2+ years case management, and proficiency with basic IT tools.

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).
• 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 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 member's needs
• Support and advocate for members and families in complicated medical situations
• Use nursing judgement in a variety of scenarios real time
• Document member interactions across databases during calls and follow procedures
• Educate members in healthcare decision making
• Lead programs and initiatives to improve performance of the new program
• Collaborate with peers and managers to improve service model performance
• Help develop and implement departmental policies and procedures
• Adapt to fast-paced environment and changes

Skills

RN license

Acute nursing

Case management

Med-surg/ICU/ER

Computer literacy

Independent worker

Education

BSN or higher

CCM (preferred)

Job description

UnitedHealthcare is seeking an experienced registered nurse to build trusted relationships with members across care continuum, providing guidance and education as a front-line clinical resource. The role emphasizes customer service with nursing judgment in a fast-paced remote setting across the United States.

Requirements include an active RN license, 4+ years acute nursing, 2+ years case management, and proficiency with basic IT tools.