Fertility Utilization Management RN - Remote

Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Utilization Management Nurse at UnitedHealth Group, you will make sure our health services are administered efficiently and effectively. You'll assess and interpret member needs and identify solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready to make an impact?

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. The work schedule for this position is 8a - 5:30p Central Time, Monday - Friday.

Primary Responsibilities

• 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
• Works with less structured, more complex issues
• Serves as a resource to others
• It feels great to have autonomy, and there's also a lot of responsibility that comes with it. In this role, you'll be accountable for making decisions that directly impact our members. And at the same time, you'll be challenged by leveraging technologies and resources in a rapidly-changing, production-driven environment

Required Qualifications

• Current unrestricted RN licensure in state of Residence
• Compact license and/or willingness to obtain additional licenses in the following states: CA, NV, NM, OK, WA and WY
• 3+ years of Managed Care and/or Clinical experience
• 1+ years of fertility experience
• Proven computer proficiency, to include strong data entry skills and the ability to navigate a Windows environment
• Willing or ability to work on core hours 8a - 5:30p CST

Preferred Qualifications

• Certified Case Manager (CCM)
• Pre-authorization experience
• Utilization Management experience
• Case Management experience
• 3rd party reproduction knowledge
• Knowledge of Milliman Criteria

The salary for this role will range from $60,200 - $107,400 annually based on full-time employment.