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PrintOnsite Utilization Management Nurse with UnitedHealthcare in Volusia County Flor
| Company: | UnitedHealth Group Company Profile | Current Opportunities (36) |
| Job Location(s): | Lake Mary |
| Employment Term: | Regular |
| Employment Type | Full Time |
| Start Date: | As soon as possible |
| Starting Salary Range: | Not Provided |
| Required Education: | Bachelor's Degree |
| Required Experience: | Open |
| Related Categories: | Miscellaneous |
Position Description
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Onsite Utilization Management Nurse with UnitedHealthcare in Volusia County Florida-328136
Description
In office and Onsite Utilization Management RN located in the commutable area of Volusia County, FL.
UnitedHealthcare is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare. We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
Primary Responsibilities:
* Ensure that health care services provided are medically necessary.
* Ensure that health care services are provided in the most appropriate setting.
* Manage medical benefits resources effectively and efficiently while ensuring quality care is provided.
* Manage members through a continuum of care including through an acute illness and transitioning to the home setting as well as providing intensive care management as to reduce readmission
* Support the establishment of a medical home and coordination of care with the PCP among various health care settings for members
* Provide a Multi-disciplinary team approach to address the member's needs from the acute care phase through the post-acute care phase
* Identify effects of underutilization as well as over-utilization.
* Identify and coordinate with QI Department in the management of quality of care issues or trends.
* Outline the program specifics with regards to Case Management areas that work collaboratively with other areas in the department.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Qualifications
Qualifications:
* Clinical Registered Nurse with current licensure in the state of Florida required
* Experience working in Medicaid and/or Medicare health care and insurance industry, including regulatory and compliance requirements
* 3 years Clinical background, experience in behavioral health and complex, community case management
* 3 years experience working in utilization management
* Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
* Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance and achieve targets
* Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
* Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
Reliable transportation and the ability to travel frequently within an assigned territory required.
Additional Assets Preferred:
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.
Job Clinical Utilization Managemen
Primary LocationUS-FL-Lake Mary
Other LocationsUS-FL-Maitland
Organization AMC Regional ICCT - Southeast
Schedule Full-time
Number of Openings 1
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