UnitedHealth Group

Preservice Review RN - VA Market Only - Remote

Posted on

May 12, 2025

Job Type

Full-Time

Role Type

License

RN

State License

Virginia

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Company Description

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

Job Description

Are you ready for your next challenge? Discover it here at UnitedHealthcare and help us reinvent the health system. This can be your opportunity to take on 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. You will discuss cases with treating physicians and other healthcare professionals to ensure our members receive the proper health services. You will be required to maintain communication with acute long-term care, acute rehabilitation, or skilled nursing facilities in order to help patients through their care plan. This is an exciting opportunity at a truly inspired organization. Join us. This can be the start of your life’s best work. 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. If you reside within the state of Virginia, you’ll enjoy the flexibility to work remotely * as you take on some tough challenges.

Requirements

Required Qualifications: Unrestricted, active RN license in VA 3+ years of RN experience in an acute setting Demonstrated ability to create, edit, save and send documents utilizing Microsoft Word Demonstrated ability to navigate a Windows environment, Microsoft Outlook, and conduct Internet searches Preferred Qualifications: HCBS authorization experience Utilization management, prior authorization, and case management experience Managed care experience Working knowledge of ICUE and CAT Launchpad

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Responsibilities

Authorization review and entry for HCBS authorizations using Virginia specific criteria Review of state specific documents required for HCBS services Communication with HCBS Providers Gather clinical information to assess and expedite care needs Consult with the Care Manager and/or Medical Director as needed to troubleshoot difficult or complex cases

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