Senior Clinical Admin Nurse

Title: Senior Clinical Admin Nurse – Remote

Location: Phoenix AZ US

Full Time

The Senior Clinical Admin Nurse will be responsible for providing individualized attention to UMR membership and covered families and serves to assist with navigation of the health care system. The purpose of the clinical liaison nurse is to help individuals live their lives to the fullest by supporting coordination and collaboration with multiple and external partners including consumers and their families/caregivers, medical, and other clinical teams.

Primary Responsibilities:

• • Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost efficiently

• • Assist members with adverse determinations, including the appeal process

• • Teach members how to navigate UMR internet-based wellness tools and resources

• • Outreach to membership providing pre-admission counseling to membership

• • Outreach to membership providing discharge planning to membership and caretakers

• • Track all activities and provide complete documentation to generate customer reporting

• • Accept referrals via designated processes, collaborate in evaluating available services, and coordinate necessary medical care and community referrals as needed

• • Comply with all policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases

• • Contribute to treatment plan discussions

• • Other duties as assigned

Candidate must be willing to work Monday – Friday 8:00 am – 5:00 pm

Required Qualifications:

• • Current and unrestricted RN compact license

• • 2+ years of acute nursing experience

• • Basic computer proficiency (ie MS Word, Outlook)

• Proven ability to function independently and responsibly with minimal supervision

Preferred Qualifications:

• • Bachelor’s degree in nursing

• • CCM

• • 2+ years managed care experience

• • Critical care, pediatric, med-surg and/or telemetry experience

• • Utilization management experience

• • Adverse Determination experience

• • Telecommute experience

Soft Skills:

• • Demonstrated excellent verbal and written communication skills

• • Excellent customer service orientation

• • Proven team player and team building skills

• Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $58,300 to $114,300 annually. 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.