Utilization Management Nurse (Los Angeles, CA )

Reply to: stcrz-3581313415@job.craigslist.org [?]

flag [?] : miscategorized prohibited spam best of Posted: 2013-01-29, 10:12PM PST

UnitedHealth Group Utilization Management Nurse - Telecommuting Position! -- (Job #508570)
Los Angeles, CA

Position Description:

On-Site at facilities in West Los Angeles, CA!

In this rewarding and challenging role, the Utilization Management Nurse is responsible for utilization management, utilization review, or concurrent review for On-Site Inpatient Care Management. The Utilization Management Nurse will perform reviews of current inpatient services, and determine medical appropriateness of inpatient services following evaluation of medical guidelines and benefit determination. Generally work is self-directed and not prescribed.

Primary Responsibilities:

? Perform utilization and concurrent review of inpatient cases using Milliman criteria
? Conduct detailed clinical chart assessments
? 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 (acute long term care, acute rehabilitation, or skilled nursing facilities)
? 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 clinical documentation at all times
? Consult with the Medical Director as needed to troubleshoot difficult or complex cases
? Identify opportunities for improved communication or processes

Keywords: Nurse, RN, Utilization, Discharge Planning, Telecommute, Telecommuter

Requirements/Qualifications:

? Current and unrestricted RN license in the State of California
? A minimum of 5 years of clinical experience
? At least 1 year of Discharge Planning experience
? Strong computer skills, must be able to type and navigate around a Windows environment
? Strong organizational skills
? Strong communication skills, written and verbal
? Must have a current and unrestricted driver's license, reliable vehicle and proof of auto insurance

Desired Assets:

? Pre-Authorization experience
? Experience working in acute long term care, acute rehabilitation, or skilled nursing facilities
? Familiarity with Milliman criteria guidelines
? Managed Care and/or Health Plan experience
? Medical Group and/or IPA experience
? Utilization Management experience
? Case Management experience
? Bachelor's Degree in Nursing
? Previous experience working in a telephonic role

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.

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.

TO APPLY, PLEASE VISIT http://careers.unitedhealthgroup.com AND SEARCH FOR JOB #508570.

RESUMES SUBMITTED VIA THIS EMAIL WILL NOT BE ABLE TO BE PROCESSED AS QUICKLY AS YOU APPLYING DIRECTLY TO THE POSITION ON OUR WEBSITE. BECOME A POTENTIAL QUALIFIED CANDIDATE QUICKER BY APPLYING AT http://careers.unitedhealthgroup.com

If you should encounter technical difficulties while applying, please contact our HRdirect hotline for assistance at 1-800-561-0861 7:00 am - 7:00 pm Central Standard Time.

Don't forget to join us on other social platforms to learn more about how to live your life's best work on:

LinkedIn Groups: http://linkd.in/uhglinkedinnursing http://linkd.in/uhglinkedinbeh http://linkd.in/uhglinkedinpharm
Twitter: http://twitter.com/uhgclinicaljobs
Facebook: http://www.facebook.com/uhgcareers

Location: Los Angeles, CA Compensation: Salaried Position.Telecommuting is ok.Principals only. Recruiters, please don't contact this job poster.Phone calls about this job are ok.Please do not contact job poster about other services, products or commercial interests.Posting ID: 3581313415

Posted: 2013-01-29, 10:12PM PST

Edited: 2013-01-29, 10:12PM PST

email to a friend

From Craiglist. Visis Amazon Store here