Saturday, October 19, 2013

Onsite Utilization Management Nurse RN


Onsite Utilization Management Nurse RN- Houston, TX

UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, weâre removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.

Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives. UnitedHealthcare is currently hiring for an Onsite Utilization Management Nurse RN in the Houston, TX market. The Onsite Utilization Management Nurse RN will be responsible for, but not limited to the following duties:

Perform utilization management, utilization review, or concurrent review (on-site or telephonic inpatient care management)

Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination

Assess and interpret customer needs and requirements

Identify solutions to non-standard requests and problems

Work with minimal guidance; seeks guidance on only the most complex tasks

Translate concepts into practice

Provide explanations and information to others on difficult issues

Coach, provide feedback, and guide others

Act as a resource for others with less experience


Basic Qualifications:

Unrestricted RN license required in state of residence

Minimum of 3 years of experience in a Managed Care and/or Clinical setting

Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment

Preferred Qualifications:

Strongly experience in Prior Authorization

Familiarity in a production environment which includes a metric of cases due on a daily basis

Ability to adapt to a changing environment very quickly

Team Player

Pre-authorization experience

Case Management experience

Certified Case Manager (CCM)

Undergraduate degree

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Apply OnlineJob Category: Medical/Health

Job Reference Code: 536065

Job Type: Full Time, Employee

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