Inpatient Care Management Nurse - Remote

Inpatient Care Management NurseOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Can you feel it? Bring that energy to a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization.What makes your nursing career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.Schedule will vary to include some weekend requirements based off the business needs.If you are located in Tennessee, you will have the flexibility to work remotely* as you take on some tough challenges.Primary Responsibilities:Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (InterQual criteria)Discuss cases with facility healthcare professionals to obtain plans-of-careCollaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization managementParticipation in discussions with the Clinical Services team to improve the progression of care to the most appropriate levelConsult with the Medical Director, as needed, for complex cases and make appropriate referrals to downstream partnersApply clinical expertise when discussing case with internal and external Case Managers and PhysiciansIdentify delays in care or services and manage with MDFollow all Standard Operating Procedures in end-to-end management of casesObtain clinical information to assess and expedite alternate levels of careFacilitate timely and appropriate care and effective discharge planningParticipate in team meetings, education, discussions, and related activitiesMaintain compliance with Federal, State and accreditation organizationsIdentify opportunities for improved communication or processesParticipate in audit activities and meetingsYou'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:Active, unrestricted RN license in state of TN3+ years of clinical nursing experience in a Hospital settingProficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platformsDesignated workspace and access to install secure high-speed internet via cable / DSL in homeReside in TNWilling or ability to work weekends as needed by the businessPreferred Qualifications:Bachelor's degreeCompact RN license2+ years of acute inpatient case management experience/utilization review1+ years of experience in Utilization Review, either within an Acute Inpatient Hospital setting or within a health insurance companyManaged care experienceExperience performing discharge planning*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter PolicyPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.