At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing… together.
The Senior Clinical Admin Nurse will be responsible for providing individualized attention to UMR membership and covered families and serves to assist with navigation of the health care system. The purpose of the clinical liaison nurse is to help individuals live their lives to the fullest by supporting coordination and collaboration with multiple and external partners including consumers and their families/caregivers, medical, and other clinical teams.
Primary Responsibilities
Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost efficiently
Assist members with adverse determinations, including the appeal process
Teach members how to navigate UMR internet-based wellness tools and resources
Outreach to membership providing pre-admission counseling to membership
Outreach to membership providing discharge planning to membership and caretakers
Track all activities and provide complete documentation to generate customer reporting
Accept referrals via designated processes, collaborate in evaluating available services, and coordinate necessary medical care and community referrals as needed
Comply with all policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases
Contribute to treatment plan discussions
Other duties as assigned
Candidate must be willing to work Monday – Friday 8:00 am – 5:00 pm.
Youll 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
Current and unrestricted RN compact license
2+ years of acute nursing experience
Basic computer proficiency (i.e. MS Word, Outlook)
Proven ability to function independently and responsibly with minimal supervision
Preferred Qualifications
Bachelors degree in nursing
CCM
2+ years managed care experience
Critical care, pediatric, med-surg and/or telemetry experience
Utilization management experience
Adverse Determination experience
Telecommute experience
Soft Skills
Demonstrated excellent verbal and written communication skills
Excellent customer service orientation
Proven team player and team building skills
Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment
All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, youll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.
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
