Senior RN Clinical Care Navigator (Remote)

UHC; Paradise Valley (NV); Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Remote work flexibility

Comprehensive benefits package

401k contribution

Job summary

UnitedHealthcare is seeking a registered nurse to join a new program providing guidance and education to members across care continuum. This role emphasizes frontline clinical support and customer service in a remote setting within the United States.

The candidate should have a current RN license, 4+ years of acute nursing experience, 2+ years in case management, and basic computer proficiency. Preferred qualifications include CCM and managed care experience.

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 and responsibly 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 comprehensive and timely follow-up with the member.
• Provide process and status on previously submitted prior authorizations or pre-determination requests.
• Effectively refers and enrolls members to appropriate internal specialists and programs, based on member's needs and eligibility.
• Support and advocate for members and families in complicated medical situations.
• Use good nursing judgement in a variety of scenarios real time.

Skills

Excellent communication

Nursing knowledge

Customer service orientation

Case management

Education

Bachelor's degree in Nursing

CCM certification

Tools

MS Word

Outlook

Job description

UnitedHealthcare is seeking a registered nurse to join a new program providing guidance and education to members across care continuum. This role emphasizes frontline clinical support and customer service in a remote setting within the United States.

The candidate should have a current RN license, 4+ years of acute nursing experience, 2+ years in case management, and basic computer proficiency. Preferred qualifications include CCM and managed care experience.