NICU Neonatal Utilization Management Nurse RN - Telecommute in HI

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. 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?

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)

If you are located in Hawaii, you will have the flexibility to telecommute* 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

This position will require active and unrestricted Nursing licensure in multiple US States. Selected candidate must be willing and able to obtain and maintain multiple state licensure. (Application fees and filing costs paid for by UHG)

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:

• Active, unrestricted RN license in the state of Hawaii
• Multiple state licensure (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses required
• 3+ years of high-risk level II or level III NICU care experience
• 3+ years of clinical experience in a maternity setting, including labor & delivery, antepartum or post-partum
• Proficient with MS Office Products (Word, Excel, Outlook) with the ability to navigate in a Windows environment
• Access to high speed internet from home
• Dedicated workspace from home
• Reside in Hawaii
• 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:

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

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

*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.

Job Keywords: RN, Registered Nurse, UR, UM, Utilization Review, Utilization Management, Concurrent Review, Milliman, Interqual, Managed Care, Insurance, Case Management, Case Manager, Discharge Planning, Chart Review, Pre-Authorization, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Honolulu, Pearl City, Hilo, HI, Hawaii