Healthcare Innovator
1 month ago
We're seeking a skilled Field Utilization Manager RN to join our team at UnitedHealth Group. As a key member of our healthcare team, you'll play a vital role in shaping the future of healthcare.
Key Responsibilities:
- Determine medical appropriateness of inpatient and outpatient services, ensuring alignment with medical guidelines and benefit determinations.
- Lead utilization management efforts, including concurrent review for members admitted to acute care settings.
- Collaborate with facilities to identify member needs on discharge and provide necessary resources and referrals.
- Employ effective use of knowledge and critical thinking skills to drive informed decision-making.
- Act as a resource for colleagues with less experience, providing guidance and support as needed.
- Work independently with minimal guidance, seeking support only for complex tasks.
- Translate complex concepts into actionable practice, ensuring seamless execution.
- Provide clear explanations and information to colleagues on challenging issues.
Requirements:
- Current, unrestricted RN license in the State of Utah or eNLC.
- 2+ years of clinical experience in a hospital, acute care, or direct care setting, with a focus on utilization management.
- Preferred qualifications include a Bachelor's degree, MCG certification, and experience working with Medicare populations and individuals with multiple comorbidities.
About UnitedHealth Group:
We're committed to helping people live healthier lives and making the healthcare system work better for everyone. Our mission is to provide equitable care that addresses health disparities and improves health outcomes. We believe in the power of diversity and inclusion, creating a healthier atmosphere for all.
Equal Employment Opportunity:
UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer, committed to diversity and inclusion. 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 any other characteristic protected by law.
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