We’re making a strong connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that’s driving the health care industry forward. As a Telephonic Utilization Review / Case Manager RN, you’ll support our Oncology and Specialty Drug member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!
This position is work at home. Work schedule expectations offer some flexibility with a combination of day and consumer hours.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Making outbound calls to providers to assess patient’s current health status
- Utilization management through evaluating appropriateness and efficiency of requested health care services, procedures, and cancer or complex condition treatments under the provisions of the applicable health benefits plan
- Identifying gaps or barriers in treatment plans
- Interacting with Medical Directors on challenging cases
- Coordinating care for members
- Documenting and tracking findings
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)
- Current, unrestricted RN license in the state of residence
- 3+ years of recent Oncology or Case Management experience in a Hospital setting, Acute Care, Direct Care experience or experience as an Complex or Oncology Telephonic Case Manager for an insurance company
- Chemotherapy or Specialty Drug administration experience
- Multiple state licensure (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses required
- Computer proficiency, to include strong data entry skills and the ability to navigate a Windows environment
- Access to high speed internet from home and a dedicated workspace for home office set up
- Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
- Ability to communicate complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
- OCN Certification
- Chemo/Bio Certification
- Certified Case Manager (CCM)
- NCCN experience
- Home care / field based case management
- Medicaid, Medicare, Managed Care experience
- A background in managed care
Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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.