Texas Licensed Utilization Management RN

UnitedHealth Group, Inc.; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

A healthcare organization is seeking a Fertility Utilization Management RN to work remotely. This role includes assessing the appropriateness of inpatient and outpatient services and solving complex issues independently. The ideal candidate will have a valid RN license, with at least 3 years of Managed Care experience and 1 year of fertility experience. Competitive pay and flexible work options available.

Qualifications

• Must have current unrestricted RN licensure in state of residence.
• 3+ years of Managed Care or Clinical experience required.
• 1+ years of fertility experience preferred.

Responsibilities

• Determine appropriateness of inpatient and outpatient services.
• Identify solutions to complex requests.
• Work autonomously on complex issues.

Skills

Managed Care experience

Clinical experience

Data entry skills

Problem-solving

Education

Current unrestricted RN licensure

Compact license

Job description

A company is looking for a Fertility Utilization Management RN - Remote.

Key Responsibilities

• Determine the appropriateness of inpatient and outpatient services based on medical guidelines and benefit determination
• Identify solutions to non-standard requests and problems while acting as a resource for others
• Work autonomously on complex issues, making decisions that directly impact members' health outcomes

Required Qualifications

• Current unrestricted RN licensure in state of residence
• Compact license and/or willingness to obtain additional licenses in specified states
• 3+ years of Managed Care and/or Clinical experience
• 1+ years of fertility experience
• Proven computer proficiency, including strong data entry skills and navigation in a Windows environment