Utilization Management RN - Office-based nursing role

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.AmeriChoice, a UnitedHealth Group company, is a recognized leader and innovator in providing managed health care solutions to its membership, which includes Medicaid, Medicare and SCHIP recipients.  With over a decade of growth and success, we are poised for continued expansion of our services in this dynamic marketplace. Our commitment to this specialized market makes a genuine difference in the lives of our 1.4 million members. Join us, do rewarding work, and build a great career. We’re looking for an RN to join our Maitland, FL team in an office-based role. As the Utilization Management RN, you would manage cases and conduct telephonic concurrent review. This is an excellent opportunity to get into a role with a lot of room for additional growth and the option to telecommute upon proven success in the role. Make a smart career move, and apply today.  Key responsibilities of the Utilization Management RN include: Working with Milliman guidelines to determine if the patient or member meets the criteria Handling inpatient cases in hospitals or acute rehab Making determinations based on the information and the Milliman guidelines Communicating with Case Managers and treating physicians regarding inpatient members Working with the discharge planners for details on patient discharge Following up with patients discharged from hospitalsRequirements include: A current, unrestricted RN license for your state of residence Familiarity with utilization management Strong communication and problem-solving skills The ability to build and maintain relationships Proficiency in Microsoft Office suite In addition, ideal assets include: Bilingual (Spanish/English) skills A Bachelor’s degree UnitedHealth Group offers a full range of comprehensive benefits to full-time and part-time employees, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.  Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V. UnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment.Keywords: RN, registered nurse, utilization management, utilization manager, um, Spanish, bilingual, nursing, nurse, office-based nursing, nursing jobs in FL