Pre-Service Review Nurse RN-Remote in PST or MST-California RN License

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Pre-Service Review Nurse RN 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? ***Although this position is remote, applicants must be located in Pacific or Mountain Time Zones*** ***Standard work week is Mon-Fri 8-5 PST or MST. There will be 2 weekend shifts required per month either one weekend or one day two separate weekends*** 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.

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 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. You’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.