Onsite Utilization Management Nurse (RN Required) (391367)
Location: Warwick Rhode Island
Description: UnitedHealth Group is currently interviewing Onsite Utilization Management Nurse (RN Required) (391367) right now, this position will be placed in Rhode Island. More complete informations about this position opportunity please give attention to these descriptions. Get better informed to determine your fit into this position. Click here to view the Realistic Job Preview:
Onsite_UM_Nurse.pdf
Responsibilities include:
Perform onsite utilization and concurrent review of inpatient cases using Milliman criteria
Discuss cases with treating physicians and other healthcare professionals to better understand plans-of-care
Participate in rounds with the Medical Director and discussing cases as needed
Determine need, if any, for intervention, and discussing with Case Managers and physicians
Identify and evaluate delays in care
Initiate a discharge planning and readmission prevention plan
Approve bed days for inpatient cases (when applicable)
Arrange alternative care services
Contact and maintain communication with acute long term care, acute rehabilitation, or skilled nursing facilities to move patients through the care continuum
Gather clinical information to assess and expedite care needs
Facilitate timely and appropriate care and effective discharge planning
Participate in team meetings, education discussions and related activities
Maintain appropriate documentation
Consult with the Medical Director as needed to troubleshoot difficult or complex cases
Identify opportunities for improved communication or processes
Participate in telephonic and in-person staff meetings
Position will work onsite at a hospital in RI.
UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:
UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.
UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.
UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.
Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.
Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.
Qualifications
Unrestricted RN license
Computer literate- ability to keyboard, Microsoft office fluency
2 or more years of recent med/surg hospital clinical experience (ICU experience is a plus).
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from other
Preferred Qualifications:
Bachelor's degree preferred
2 plus years of case management experience- certification a plus
Discharge planning experience
Utilization review
experience for an insurance company , managed care environment or Hospital
Familarity with Milliman Guidelines
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to UnitedHealth Group.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Sat, 04 Aug 2012 01:32:49 GMT
Apply Onsite Utilization Management Nurse (RN Required) (391367) Here
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