Job Description

Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Utilization Management Nurse 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 telecommute* from anywhere within the U.S. as you take on some tough challenges.

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:

* Unrestricted RN license required in state of residence
* 3+ years of NICU Clinical experience
* 3+ years of hands-on clinical experience
* If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders.

Preferred Qualifications:

* Pre-authorization experience
* Utilization Management experience
* Case Management experience
* Knowledge of Milliman Criteria
* Certified Case Manager (CCM)

Join us and discover how a superior professional environment and incredible opportunities make a difference in the lives of patients. We're a place where leaders thrive, and innovation abounds. Seize this opportunity to achieve your life's best work.(sm)

Colorado Residents Only: The salary/hourly range for Colorado residents is $53,300 to $95,100 (add additional reference for sales and physicians). Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

Key words: NICU, Utilization Management, RN, Registered Nurse, UM, Telecommute