Remote Inpatient Care Management Nurse RN

About the role

Optum, part of UnitedHealth Group, is hiring a remote Inpatient Care Management Nurse RN. The nurse ensures proper use of health services by assessing and interpreting member needs and finding solutions that help them live healthier lives. The role is fully remote, with standard hours of 8:00 a.m. to 5:00 p.m. in the candidate's local time zone (EST or CST), and a consistent schedule of Sunday through Thursday or Tuesday through Saturday after training.

Key responsibilities

• Perform initial and concurrent review of inpatient cases using evidence-based criteria (InterQual)
• Discuss cases with facility healthcare professionals to obtain plans of care
• Collaborate with Optum Enterprise Clinical Services Medical Directors on utilization management
• Help the Clinical Services team improve the progression of care to the most appropriate level
• Consult the Medical Director on complex cases and refer to downstream partners
• Manage care delays and expedite alternate levels of care
• Facilitate timely care and effective discharge planning
• Take part in team meetings, education and audit activities, and identify process improvements
• Maintain compliance with federal, state and accreditation requirements

Required profile

• Active, unrestricted RN license in the state of residence
• 1+ year of recent clinical nursing experience in an acute inpatient hospital
• 1+ year of utilization review experience using InterQual guidelines, in a hospital or health insurance company
• Permanent residence in the Eastern or Central Time Zone
• Preferred: Bachelor's degree, Compact RN license, 2+ years of acute inpatient case management or utilization review, managed care experience

Required skills

• Proficiency with Windows, IM, Excel (Microsoft Suite) and Outlook
• Experience with clinical platforms
• Secure high-speed internet connection at home

What we offer

• Salary of $60,200 to $107,400 per year depending on experience and education
• Comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution
• Career development opportunities