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Optum is a global organization that delivers care
Location:
Phoenix, AZ
Description:
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact with an Early Careers research analyst opportunity on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Integrated Care Team leverages a cross-functional approach, supporting the member end to end, with close collaboration and co-management. Generally, work is self-directed and not prescribed; is able to work with less structured and more complex issues. The Preservice Review/Prior Authorization RN will manage the full array of health care services, spanning both outpatient and Inpatient settings and with support from some specialized clinical teams, serves as a resource to others. This new cross-functional collaboration provides an opportunity to deliver the next generation clinical model, integrating services from precertification, inpatient concurrent review, post-acute review, discharge planning, medical and behavioral care management and prevention to improve quality of care and patient outcomes. Candidates for this position would be required to support cross-training to multiple roles: Prior Authorization (PA), Post-Acute Care Management (PACM), Inpatient Care Management (ICM) and Discharge Care Management (DCM) to support fluctuating inventory within the Integrated Care Team. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Perform initial and ongoing reviews pertaining to primary role (PA, ICM, DCM, PACM), appropriately applying clinical criteria (InterQual, policies, National and Local Coverage Determinations) for approval and sending to Medical Directors if review is necessary for determining an adverse determinationCollaborate with Medical Directors, clinical peers and Health Plan partners on performing appropriate clinical decision making and/or referralsApply clinical expertise when discussing case with internal and external Case Managers and PhysiciansFollow all Standard Operating Procedures in end-to-end management of casesParticipate in team meetings, education discussions and related activitiesMaintain compliance with Federal, State and accreditation organizations You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications: A current, unrestricted RN license in State of residency3+ years of RN experienceProficient computer skills including Microsoft Office Suite (Teams, Word, Excel, and Outlook)Demonstrated ability to work independentlyDemonstrates effective verbal and written communication skillsAbility to work weekends Preferred Qualifications: Bachelor of Science degree in Nursing or a Master of Science degree in NursingCompact RN License2+ years of Case Management experienceClinical experience in an inpatient/acute setting, long-term care, acute rehabilitation, or skilled nursing facilitiesExperience performing Discharge Planning Experience with InterQual Utilization Review experience California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $27.07 to $53.08 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Company:
Unitedhealth Group
Posted:
January 2 on WhatJobs
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Optum is a global organization that delivers care is a Jobs Optum is a Global Organization Job at Unitedhealth Group located in Phoenix AZ. Find other listings like Optum is a global organization that delivers care by searching Oodle for Jobs Optum is a Global Organization Jobs.
Optum is a global organization that delivers care is a Jobs Optum is a Global Organization Job at Unitedhealth Group located in Phoenix AZ. Find other listings like Optum is a global organization that delivers care by searching Oodle for Jobs Optum is a Global Organization Jobs.