Field Utilization Manager RN

2 months ago

Ogden, United States UnitedHealth Group Full time

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Primary Responsibilities: Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination Utilization management which includes Concurrent Review for members admitted to the acute care setting Identify member needs on discharge in collaboration with facility Identify appropriate resources and referrals needed Employ effective use of knowledge, critical thinking skills Act as a resource for others with less experience Work with minimal guidance; seek guidance on only the most complex tasks Translate concepts into practice Provide explanations and information to others on difficult issues Other assigned duties You'll 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, unrestricted RN license in the State of Utah or eNLC 2+ years of clinical experience in a hospital, acute care, and direct care or utilization management Preferred Qualifications: Bachelor's degree MCG certification, if does not have certification, must obtain within 1 year of hire One of the following certifications: ACM, CCM, CMC, and/or CMCN- 2+ years of UM/CM experience Experience working with Medicare population and individuals with multiple co - morbidities 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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

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