Fertility Utilization Management RN - Remote
$60.2k - $107.4kUnitedhealth Group
About This Role
As a Fertility Utilization Management RN at UnitedHealth Group, you will ensure health services are administered efficiently and effectively, assessing member needs and identifying solutions to help them live healthier lives. This remote position is ideal for those looking to make a significant impact in healthcare.
Highlights
- Pay: $60,200 - $107,400/year
- Location: Des Moines, IA
- Schedule: Full Time, Day shift
- Residency: Must reside in the U.S.
What You'll Do
- Determine the appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
- Identify solutions to non-standard requests and problems
- Translate concepts into practice
- Act as a resource for others; provide explanations and information on difficult issues
- Generally, work is self-directed and not prescribed
- Work with less structured, more complex issues
- Serve as a resource to others
- Make decisions that directly impact members while leveraging technologies and resources
Requirements
Education:
- Current unrestricted RN licensure in state of residence
Experience:
- 3+ years of Managed Care and/or Clinical experience
- 1+ years of fertility experience
Licenses & Certifications:
- Compact license and/or willingness to obtain additional licenses in CA, NV, NM, OK, WA, and WY required
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase and 401k contribution
About UnitedHealth Group
UnitedHealth Group is a leading healthcare provider committed to delivering exceptional patient care. They harness technology and innovation to make healthcare simpler, more affordable, and more connected for the people they serve. The organization values inclusion and empowers employees to bring their authentic selves to work.
#J-18808-Ljbffr- ...UnitedHealth Group is seeking a Fertility Utilization Management RN in the United States. This remote role requires 3+ years in managed care and fertility experience, plus an unrestricted RN license in the resident state. The position is full-time with day shifts, based...Remote workFull timeDay shift
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- ...CVS Health is seeking an experienced Registered Nurse for a remote Utilization Management Nurse Consultant role focused on Medicare joint procedures.... ...care and utilization. The position requires 3+ years RN experience, an active RN license, an associate degree in nursing...Remote work
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- ...support patient care initiatives, the full-time Florida Licensed Utilization Management RN will monitor admissions, perform medical necessity reviews,... ...with the multidisciplinary care team in a fully remote setting. Key responsibilities Monitor admissions and perform...Remote workFull time
- ...Humana is seeking a remote Utilization Management Behavioral Health Professional 2 in Indiana. The role requires an active RN license in Indiana, an ASN (BSN preferred), and 1+ year of clinical and managed care experience. You will coordinate with providers and members...Remote work
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$47.37 per hour
...Lancesoft is seeking a Care Review Clinician for a remote 3-month assignment. You will work with the Utilization Management team to review inpatient cases, authorize care,... ...regulations. The role requires an active RN/LPN/LVN license and 2–4 years of clinical experience...Remote workHourly pay- ...Services and Supports, the full-time Massachusetts Licensed Utilization Management RN will manage clinical determinations, authorization support, and appeals in a hybrid role that is approximately 75% remote and 25% onsite for meetings and training. Key responsibilities...Remote workFull time
- ...CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN), remote and full-time with a weekend schedule after training. You’ll review clinical information for coverage determinations, apply guidelines, and coordinate with care teams...Remote workFull timeWeekend workAfternoon shiftWeekday work
- ...Health is seeking an experienced Registered Nurse to support utilization management and care coordination from a remote work setup within the United States. Candidates should have 2+ years of acute/critical care RN experience and an active RN license in their state of...Remote work
- ...CVS Health Corporation is seeking a Utilization Management Nurse Consultant (RN) for remote work supporting prior authorization and utilization management. You will review requests, evaluate medical necessity, and collaborate with care teams to ensure timely, cost-effective...Remote work
- ...seeking a Pre-Authorization Registered Nurse for a remote, full-time role based in Virginia. The RN will review prior authorization requests,... ...appropriate care settings, and educate providers on utilization and management processes. Requirements include an active RN...Remote workFull time
- ...Humana Inc. invites a qualified Utilization Management Registered Nurse to interpret and support coordination, documentation and communications... ...acute care services. Required qualifications include an active RN license in your state, over one year of clinical RN experience...Remote work
- ...Hanker Systems Inc. is seeking a skilled Registered Nurse for Utilization Management/Utilization Review in a 100% remote role. California licensure is required, with 3+ years in acute hospital care management and recent utilization review experience. Epic proficiency...Remote work
- ...A healthcare management organization is seeking a Utilization Management Nurse to oversee health service utilization while... .... This role requires an active LPN/RN license, and candidates should have... ...benefits package including remote work options. #J-18808-Ljbffr...Remote work
- ...Humana Inc. seeks a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical... ...report to the Manager of Utilization Management and work on a remote team focused on delivering appropriate care in the right setting...Remote work
- ...Sentara Health Plans is hiring a Clinical Claims Reviewer/RN for a remote role. This full-time position involves utilization management and post-payment review across various care settings, with RN licensure and coding credentials under consideration. The role offers...Remote workFull time
- ...Logan Health is hiring a Utilization Management Specialist to join the UM team. The role focuses on reviewing admissions, validating documentation... ..., communication and EMR proficiency, with a four-day work week and remote options for Montana residents. #J-18808-LjbffrRemote work
- ...Logan Health Medical Center is seeking a Utilization Management Specialist to review admissions across... ...appropriate status. This role suits an RN or Social Worker with acute care... ...and insurers. The position is fully remote for Montana residents and offers a four...Remote work
- ...Cleveland Clinic is seeking an Utilization Management RN Reviewer to support remote operations from home. The role covers admission and concurrent reviews, and ensures medical necessity criteria are applied to hospital stays and discharges. Qualifications include RN...Remote work
$70k - $75k
...Utilization Management Registered Nurse (RN) - Remote Full-time WHO IS GUIDEHEALTH? Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home- ...CVS Health is seeking an Utilization Management Nurse Consultant - Clinical Precertification RN (Medicare) for a remote, full-time role. You will review cases, determine coverage, and collaborate with care teams to ensure appropriate care timing and setting. The position...Remote workFull timeMonday to Friday
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$59.5k - $116.6k
...UnitedHealth Group is seeking a Utilization Management Nurse RN to work remotely from anywhere in the U.S. This role involves ensuring efficient health services and requires an active RN license and 3+ years of Managed Care or Clinical experience. The successful candidate...Remote workWeekend work- ...Humana Inc. seeks a Utilization Management Registered Nurse to interpret and support coordination, documentation and communication of medical services and benefit determinations. You will report to the Manager of Utilization Management and serve on the One Home/Home...Remote work
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