Prior Authorization Nurse (RN) - 4 day work week (Thursday - Sunday 10 hour days) (505259)
Location: Trumbull Connecticut
Description: UnitedHealth Group is currently seeking to employ Prior Authorization Nurse (RN) - 4 day work week (Thursday - Sunday 10 hour days) (505259) right now, this job will be placed in Connecticut. More complete informations about this job opportunity please give attention to these descriptions. This position will work Thursday thr! ough Sunday for 10 hour.
Position is responsible for utilization review of outpatient service for Prior Authorization.
Determines medical appropriateness of outpatient services following evaluation of medical guidelines and benefit determination
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UHC_Telephonic_UM_Nurse.pdf
Utilization Management Nurse responsibilities include:
Perform utilization review
Determine medical appropriateness of 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
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 go! vernment agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.
Together, we’re 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.
Qualifications
Current and unrestricted RN license in state position is located
2 years minimum clinical experience as an RN
Strong computer proficiency, must be able to type in addition to navigating around a Windows environment and using multiple applications simultaneously
Ability to work Thursday – Sunday 10 hour days.
Additional Qualifications! Preferred:
BSN
Experience working within the Healthca! re and/or Insurance industry
ICU experience
Experience working in utilization management
Knowledge of ICD 9/CPT codes
Experience working with Medicare / Medicaid
Experience with CMS Coverage Guidelines
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.
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to UnitedHealth Group.
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This job starts available on: Thu, 18 Oct 2012 21:52:57 GMT