Remote Utilization Management RN — Health Plan Expert

IntelliResume; California (MO); Remote; 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's Optum seeks a Utilization Management Nurse to ensure efficient, appropriate care. You will perform prior authorization reviews for skilled nursing facilities and acute inpatient rehabilitation, and determine medical necessity based on guidelines.

This full-time, day-shift, remote role requires residency in Pacific or Mountain Time Zones. Pay ranges from $29.00 to $52.00 per hour, with a comprehensive benefits package and incentive programs.

Qualifications

• Compact RN License required.
• 3+ years of Managed Care and/or clinical experience.
• Prior Utilization Management experience (not case management).

Responsibilities

• Perform prior authorization review of skilled nursing facilities and acute inpatient rehabilitation.
• Determine medical appropriateness of level of care based on guidelines.
• Handle less structured, more complex issues.
• Identify solutions to non-standard requests and problems.
• Translate concepts into practice.
• Act as a resource for others, explaining difficult issues.

Skills

RN License (Compact)

Managed Care experience

Utilization Management

Prior Authorization

Education

RN License (Compact)

Job description

UnitedHealth Group's Optum seeks a Utilization Management Nurse to ensure efficient, appropriate care. You will perform prior authorization reviews for skilled nursing facilities and acute inpatient rehabilitation, and determine medical necessity based on guidelines.

This full-time, day-shift, remote role requires residency in Pacific or Mountain Time Zones. Pay ranges from $29.00 to $52.00 per hour, with a comprehensive benefits package and incentive programs.