Remote Utilization Management RN-Impactful Care

UnitedHealth Group; Sacramento (CA); Remote; Confidential; 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 and effective health services administration. The role involves assessing member needs, interpreting guidelines, and recommending appropriate care levels to support healthier outcomes.

This remote position is restricted to applicants located in Pacific or Mountain Time Zones, offering remote work with autonomy and clear objectives.

Qualifications

• RN license required and compact license
• 3+ years in Managed Care or clinical roles
• Experience in Utilization Management (not case management)
• Proficient with MS Outlook, Word and Excel

Responsibilities

• Review and authorize pertinent care as part of Utilization Management.
• Assess member needs and interpret guidelines to determine medical necessity.
• Communicate decisions and rationale to care teams and stakeholders.
• Provide information and support on difficult issues across care settings.
• Operate with a self-directed approach in a flexible, production-driven environment.

Skills

RN licensure

Managed Care

Utilization Management

MS Office

Tools

Epic

Cerner

CareAdvance

Milliman Criteria

Job description

UnitedHealth Group is seeking an experienced Utilization Management Nurse to ensure efficient and effective health services administration. The role involves assessing member needs, interpreting guidelines, and recommending appropriate care levels to support healthier outcomes.

This remote position is restricted to applicants located in Pacific or Mountain Time Zones, offering remote work with autonomy and clear objectives.