Utilization Review/ Preservice Review Nurse RN (529790)
Location: Trumbull Connecticut
Description: UnitedHealth Group is hiring Utilization Review/ Preservice Review Nurse RN (529790) right now, this job will be placed in Connecticut. For detail informations about this job opportunity please read the description below. Want to learn more before applying for this role? Click here to view the Realistic Job Preview: UHC_Telephonic_UM_Nurse.pdf
This Ut! ilization Management Nurse is based in Trumbull, CT! Utilization Management Nurse responsibilities include:
Perform utilization and concurrent review using Milliman criteria
Conduct clinical chart assessments
Discuss cases with treating physicians and other healthcare professionals to better understand plans-of-care
Identify and evaluate delays in care
Initiate a discharge planning and readmission prevention plan when applicable
Approve bed days for inpatient cases when applicable
Arrange alternative care services; Contact and maintain communication with acute long term care, acute rehabilitation, or skilled nursing facilities to move patients through the care continuum
Gather clinical information to assess and expedite care needs
Maintain appropriate documentation
Consult with the Medical Director as needed to troubleshoot difficult or complex cases
Participate in telephonic and in-person staff meetings
What makes y! our clinical career greater with UnitedHealth Group? You can i! mprove the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
Requirements
Requirements:
RN - current and unrestricted license in CT
3 years of clinical experience
Previous hospital experience
MS Word, Excel, Outlook expertise
Strong communication skills
Excellent organizational skills
Team-oriented
Additional Assets Preferred:
BSN
Prior authorization/UM/Case Management experience
Previous insurance experience
Medicare/Medicaid expertise
UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve healt! h 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.
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.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
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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.
If you interested on this job just click on the Apply button, you will be redirected to the official website
This job starts available on: Tue, 13 Aug 2013 07:22:51 GMT
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