21 days old

Prior Authorization RN - Telecommute

Nashville, TN 37201 Work Remotely
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  • Job Code
    895193
  • Jobs Rated
    144th

Are you ready for your next challenge? Discover it here at UnitedHealthcare and help us reinvent the health system. This can be your opportunity to take on a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. You will discuss cases with treating physicians and other healthcare professionals to ensure our members receive the proper health services. You will be required to maintain communication with acute long-term care, acute rehabilitation, or skilled nursing facilities in order to help patients through their care plan. This is an exciting opportunity at a truly inspired organization. Join us. This can be the start of your life's best work.(sm)  

 

What makes your nursing career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

 

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

 

Primary Responsibilities:

  • Perform clinical coverage review services, which require interpretation of state and federal mandates, applicable benefit language, and consideration of relevant clinical information
  • Function as a member of a self-directed team to meet specific individual and team performance metrics
  • Ability to communicate in writing and verbally, all types of benefit determinations including decisions regarding coverage guidelines, contractual limitations and reimbursement determinations
  • Telephonic discussion with health care providers and / or members to explain benefit coverage determinations and to obtain additional clinical information
  • Acts as a resource for others with less experience
  • Work independently and collaborating with Medical Directors and non-clinical partners
  • Adapt to a highly changing environment and a heavy case load

This position may require a Monday thru Friday schedule that may require flex weekends, rotating weekends or a flexible schedule. A Tuesday thru Saturday schedule may also be available. Specific locations may require the candidate to start as office based or reside within a specific state. This is an hourly position that is non-exempt and overtime eligible.

 

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.

 

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Jobs Rated Reports for Author

Posted: 2020-10-05 Expires: 2020-11-05

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Prior Authorization RN - Telecommute

UnitedHealth Group
Nashville, TN 37201

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Author
144th2018 - Author
Overall Rating: 144/220
Median Salary: $61,820

Work Environment
Fair
120/220
Stress
High
166/220
Growth
Poor
133/220
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