Remote Utilization Management RN - Driving Care Outcomes

Colorado Psychiatric; Sacramento (CA); Hybrid; USD 40,000 - 72,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Job summary

UnitedHealth Group is seeking an experienced Utilization Management Nurse to ensure efficient, evidence-based care across the continuum. This role focuses on prior authorization review for skilled nursing, inpatient rehabilitation and LTAC, translating guidelines into practical decisions.

You will work remotely within Pacific or Mountain Time Zones, enjoy autonomy, and help members live healthier lives while leveraging tools and resources in a dynamic, production-driven environment.

Qualifications

• Compact RN License.
• 3+ years of Managed Care and/or clinical experience.
• Prior Utilization Management experience (not case management).
• Proven basic computer skills with MS Outlook, Word and Excel.

Responsibilities

• Utilization management including Prior Authorization Review for SNF, inpatient rehab and LTAC.
• Determine medical appropriateness of level of care per guidelines and benefit determinations.
• Work is self-directed and not prescribed.
• Handle less structured, more complex issues.
• Identify solutions to non-standard requests and problems.
• Translate concepts into practice and act as a resource.

Skills

Managed care experience

Clinical experience

MS Outlook/Word/Excel

Education

Compact RN License

Tools

Epic

Cerner

TMC

Meditech

Care Advance

Job description

UnitedHealth Group is seeking an experienced Utilization Management Nurse to ensure efficient, evidence-based care across the continuum. This role focuses on prior authorization review for skilled nursing, inpatient rehabilitation and LTAC, translating guidelines into practical decisions.

You will work remotely within Pacific or Mountain Time Zones, enjoy autonomy, and help members live healthier lives while leveraging tools and resources in a dynamic, production-driven environment.