Senior Clinical Care Navigator - Remote RN

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

Job summary

UnitedHealthcare is hiring a Family Advocate Support CARE - Senior Clinical Admin Nurse to provide individualized navigation assistance to UMR CARE members and families, coordinating care with clinical teams and external partners. This remote role supports members across the U.S.

with education, outreach, and discharge planning. Required: RN license, 2+ years of relevant nursing experience, Medicaid waiver familiarity; preferred: Bachelor's in nursing, CCM, and telecommute experience.

Qualifications

• Current and unrestricted RN license.
• Ability to obtain additional licenses as required.
• 2+ years of acute nursing experience.
• 2+ years of behavioral health nursing experience.
• 2+ years of Medicaid waiver experience.
• Med-surg, critical care and/or ER experience.
• Basic computer proficiency (MS Word, Outlook).
• Proven ability to function independently with minimal supervision.

Responsibilities

• Provide members with tools, education, and support to navigate the health care system and manage health concerns effectively and cost efficiently.
• Assist members with adverse determinations, including the appeals process.
• Educate members on how to use patient resources and wellness tools.
• Conduct member outreach for pre-admission counseling and discharge planning.
• Track activities and maintain documentation to support reporting.
• Coordinate medical care and community referrals as needed.
• Follow policies, procedures, and documentation standards.
• Participate in treatment plan discussions.

Skills

Communication skills

Customer service

Independent work

Team player

Education

Bachelor’s degree in nursing

Tools

MS Word

Outlook

Job description

UnitedHealthcare is hiring a Family Advocate Support CARE - Senior Clinical Admin Nurse to provide individualized navigation assistance to UMR CARE members and families, coordinating care with clinical teams and external partners. This remote role supports members across the U.S.

with education, outreach, and discharge planning. Required: RN license, 2+ years of relevant nursing experience, Medicaid waiver familiarity; preferred: Bachelor's in nursing, CCM, and telecommute experience.