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Preservice Review RN PST Including Weekends - Remote - Remote Eligible

Evaluate inpatient and outpatient service requests based on medical guidelines and benefits
Seattle
Entry Level
$28 – 50 USD / hour
17 hours agoBe an early applicant
Optum

Optum

A health services and innovation company offering healthcare solutions to improve the efficiency of the healthcare system.

Caring. Connecting. Growing Together.

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Preservice Review Nurse RN at UnitedHealth Group, you will make sure our health services are administered efficiently and effectively. You'll assess and interpret member needs and identify solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready to make an impact?

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

This position requires you to work 8am to 5pm Pacific Standard Time supporting this region.

Primary Responsibilities:

  • Determine the appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
  • Identify solutions to non-standard requests and problems
  • Translate concepts into practice
  • Act as a resource for others; provide explanations and information on difficult issues

It feels great to have autonomy, and there's also a lot of responsibility that comes with it. In this role, you'll be accountable for making decisions that directly impact our members. And at the same time, you'll be challenged by leveraging technologies and resources in a rapidly-changing, production-driven environment.

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:

  • Undergraduate degree or equivalent experience
  • Unrestricted RN license in state of residence
  • 1+ years of Managed Care and/or Clinical experience
  • Work Pacific Standard Time schedule (PST)
  • Ability to work a full-time schedule, to include weekends

Preferred Qualifications:

  • Compact RN License
  • WA State RN License
  • Pre-authorization experience
  • Utilization Management experience
  • Case Management experience
  • Knowledge of Milliman Criteria

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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Preservice Review RN PST Including Weekends - Remote - Remote Eligible
Seattle
$28 – 50 USD / hour
Registered Nurse
About Optum
A health services and innovation company offering healthcare solutions to improve the efficiency of the healthcare system.