Requisition Number: 2243448
Job Category: Nursing
Primary Location: Little Rock, AR, US
(Remote considered)
At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
If you reside within a compact state, you’ll enjoy the flexibility to work remotely * as you take on some tough challenges.
Primary Responsibilities:
- Secure, track and review records via multiple media
- Identify program specific documents within member’s records
- Submit coverage checks and claims to Allstate on members behalf
- Obtain appropriate medical records from various health care providers
- Use clinical judgement to prepare records for external review
- Use clinical judgement to triage patients for program candidacy
- Make appropriate referrals into various programs in a timely manner
- Act as a liaison between COE facilities and Care Managers or referring parties
- Facilitate patient participation in Case Management with regular medical carrier
- Skilled telecommunications in a high-touch member program
- Encourage and support members participating in the program with sensitivity and compassion
- Educate members regarding program policies and procedures
- Evaluate appointments to determine if they fall under the COE guidelines
- Assist members with travel questions related to medical necessities
- Receive and collects data necessary for program enrollment, review, and reporting
- Responsible for providing seamless customer service to include updating member information, vendors portals, and internal documentation
- Participate in staff meetings
- Notify patients, COE facilities and Care Managers when program benefit end date is approaching
- Develop and maintain a positive relationship with external vendors
- Develop and maintain a positive enthusiastic working relationship with all staff, in addition to all members, caregivers, donors and providers
- Solid ability to identify appropriate resources for research and problem resolution
- Ability to triage telephone calls received in a queue
- Other duties as assigned by supervisor
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:
- Current and unrestricted compact state RN license
- 1+ years of clinical nursing experience
- Ability to work in a fast-paced multi-tasking environment
- Basic proficiency with Microsoft Word, Excel, Teams and Outlook
Preferred Qualifications:
- Associates or Bachelors of Science in Nursing
- 3+ years of clinical nursing experience
- Case management experience
Soft Skills:
- Demonstrated excellent verbal and written communication skills
- Effective organizational and prioritization skills
- Proven interpersonal skills with ability to function as a positive team member
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. 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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.