[Hiring] Senior Clinical Admin Nurse @UnitedHealth Group

Role Description

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.

• 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.

Qualifications

• Current and unrestricted RN compact license.
• 4+ years of acute nursing experience.
• 2+ years of case management experience.
• Med-surg, critical care and/or ER experience.
• Basic computer proficiency (ie MS Word, Outlook).
• Proven ability to function independently and responsibly with minimal supervision.

Requirements

• Bachelor’s degree in nursing (preferred).
• CCM (preferred).
• 2+ years of managed care experience (preferred).
• 2+ years of behavioral health nursing experience (preferred).
• Critical care, pediatric, med-surg and/or telemetry experience (preferred).
• Utilization management experience (preferred).
• Adverse Determination experience (preferred).
• Telecommute experience (preferred).

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).
• Salary range: $60,200 - $107,400 annually based on full-time employment.

Application Deadline

This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.