Field Utilization Manager RN
2 weeks ago
Are you passionate about shaping the future of healthcare? Do you want to be part of a team that's revolutionizing the way healthcare is delivered? We're looking for a skilled Field Utilization Manager RN to join our team at UnitedHealth Group.
Job Summary:We're seeking a highly motivated and experienced Field Utilization Manager RN to lead our efforts in determining medical appropriateness of inpatient and outpatient services. As a key member of our team, you'll be responsible for evaluating medical guidelines and benefit determination, identifying member needs on discharge, and collaborating with facilities to ensure seamless care transitions.
Key Responsibilities:- Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
- Utilization management, including 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, and 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 and provide explanations and information to others on difficult issues
- 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, and experience working with Medicare population and individuals with multiple co-morbidities
We believe everyone deserves the opportunity to live their healthiest life. Our mission is to help people live healthier lives and make the health system work better for everyone. We're committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.
We're 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.
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