Inpatient Care Management Nurse RN EST Time Zone Telecommute

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Can you feel it? Bring that energy to 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.

As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready for a new path? Join us and start doing 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.

Work schedule will be business hours Monday to Friday in the Eastern Time Zone.

If you are located in the EST time zone hours, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:
  • Perform initial and concurrent review of inpatient cases applying evidence based criteria for approval and sending to Medical Directors if review is necessary for determining an adverse determination
  • Discuss cases with facility healthcare professionals to obtain plans-of-care
  • Collaborate with UnitedHealthcare Medical Directors on performing utilization management
  • Participation in discussions with the Clinical Services team to improve the progression of care to the most appropriate level
  • Consult with the Medical Director as needed for complex cases and make appropriate referrals to sister segments
  • Apply clinical expertise when discussing case with internal and external Case Managers and Physicians
  • Identify delays in care or services and manage with MD
  • Follow all Standard Operating Procedures in end to end management of cases
  • Obtain clinical information to assess and expedite alternate levels of care
  • Facilitate timely and appropriate care and effective discharge planning
  • Participate in team meetings, education discussions and related activities
  • Maintain compliance with Federal, State and accreditation organizations
  • Identify opportunities for improved communication or processes
  • Participate in telephonic and in-person staff meetings
  • Plan for InterQual training
  • Build and maintain relationships
  • Gather clinical information to assess and expedite care needs
  • Maintain appropriate and accurate documentation


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:
  • A current, unrestricted RN license
  • 3+ years of clinical nursing experience practicing clinically (Acute Inpatient, SNF/AIR/LTAC, Emergency Department, Urgent Care, Doctor's Office, School Nurse)
  • Experience in acute, long term care, acute rehabilitation, or skilled nursing facilities
  • Demonstrate a proficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platforms
  • Have a designated work space and access to install secure high speed internet via cable / DSL in home
  • Able to work 8AM to 5 PM EST Monday to Friday


Preferred Qualifications:
  • Bachelor's degree
  • 1+ years of experience involving utilization review and evidence-based guidelines (i.e. MCG, InterQual Guidelines)
  • Experience in discharge planning and /or chart review
  • Compact license
  • Experience with utilization review for an insurance company or in a managed care environment
  • Familiarity with InterQual criteria guidelines


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

Connecticut Residents Only: The salary range for Connecticut residents is $53,300 to $95,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives

Diversity creates a healthier atmosphere: UnitedHealth Group is 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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Utilization Review; Utilization Management; concurrent Review; MCG; Milliman; Interqual; UM; UR; RN; Registered Nurse; Inpatient; Discharge Planning, telecommute, telecommuting, telecommuter, remote

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