***Although this position is remote, applicants must be located in Pacific or Mountain Time Zones***

If you are located in Pacific or Mountain time zones, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities

• Positions in this function require unrestricted compact RN licensure
• Function is responsible for utilization management which includes Prior Authorization Review of skilled nursing facility, acute inpatient rehabilitation and long-term acute care hospital
• Determines medical appropriateness of level of care following evaluation of medical guidelines and benefit determination
• Generally, work is self-directed and not prescribed
• Works with less structured, more complex issues
• 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

Required Qualifications

• Compact RN License
• 3+ years of Managed Care and/or clinical experience
• Prior Utilization Management experience (not case management)
• Proven basic computer skills with MS Outlook, Word and Excel

Preferred Qualifications

• Prior-authorization experience
• Multi-specialty experience
• Experience in a skilled nursing facility or inpatient rehabilitation facility
• Multiple EMR experience including Epic, Cerner, TMC, Meditech or Care Advance
• Knowledge of Milliman Criteria

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.