UnitedHealth Group Clinical Review Nurse Specialist, RN - Telecommute - Tampa, FL preferred in Tampa, Florida
For those who want to invent the future of health care, here's your opportunity.
We're going beyond basic care to health programs integrated across the entire continuum of care.
Join us and help people live healthier lives while doing your life's best work.(sm) The Clinical Review Nurse Specialist applies clinical knowledge and expertise with established clinical guidelines to provide clients with accurate and timely prospective, concurrent and retrospective clinical reviews for all home health referrals managed by PMSI/PMIs Home Health (Critical Care) and Clinical Services Department. The Clinical Review Nurse Specialist interacts directly with discharge planners, home health operations, claims adjusters, and case managers to assess, plan and coordinate the execution of Home Health services and DME.
This is a telecommute position, but candidates based in the Tampa, Florida area will be given preference Primary Responsibilities: Positions in this function include RN roles (with current unrestricted licensure in applicable state) responsible for providing clinical expertise in any of the following areas Clinical Interface/Liaison (clinical problem solver with facilities, providers, carriers; resolution of issues concerning members, benefit interpretation, program definition and clarification) Clinical Operations Analysis (monitors and analyzes medical management activities; provides analytical support to clinical programs; may perform clinical assessments and clinical audits) Clinical Training (planning, coordinating, delivering and evaluating clinical training) Clinical Writing (writing nursing tools and reference information to support the design of clinical products and services) Clinical Program Management (development, implementation and/or on-going management and administration of a clinical program(s).
Provides strategic oversight and support, measurement standards and revisions as needed for delivery of programs focused on quality, affordability and outcomes.) Reviews the work of others Develops innovative approaches Sought out as expert Serves as a leader / mentor Required Qualifications: Current and unrestricted RN license Minimum 5 years of Clinical Nursing experience Proficiency in Microsoft Word, Excel and Outlook Preferred Qualifications: Prior Workers Compensation experience Prior Case Management and/or Utilization Review experience Home Health nursing experience Previous experience working as a telecommuter strongly preferred Additional clinical certifications such as Certified Case Manager (CCM), Life Care Planner (LCP), Certified Insurance Rehabilitation Specialist (CIRS), Certified Rehabilitation Registered Nurse (CRRN), Certified Disability Management Specialist (CDMS) UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 6, we are totally focused on innovation and change.
We work a little harder.
We aim a little higher.
We expect more from ourselves and each other.
And at the end of the day, we're doing a lot of good.Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever.
Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.Come to UnitedHealth Group, and share your ideas and your passion for doing more.
We have roles that will fit your skills and knowledge.
We have diverse opportunities that will fit your dreams. 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: Clinical Administrator, Nursing, Consultant, RN, Licensed, Tampa, FL, Florida, Work from home, Remote, Telecommute fc42666f-de43-4615-8a09-4a38abc9a022
Clinical Review Nurse Specialist, RN - Telecommute - Tampa, FL preferred Florida-Tampa 718057