Want to learn more before applying for this role? Click here to view the Realistic Job Preview: UHC_Telephonic_UM_Nurse.pdf

UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

·         UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

·         UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

·         UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.

UnitedHealthcare is currently seeking a Utilization Management Nurse in the Dallas/Fort Worth, TX area. The Utilization Management Nurse will be responsible for, but not limited to the following duties include:

·         -Perform utilization management, utilization review, or concurrent review (telephonic inpatient care management)

·        - Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination

·       -  Assess and interpret customer needs and requirements

·       -  Identify solutions to non-standard requests and problems

·         -Work with minimal guidance; seeks guidance on only the most complex tasks

·        - Translate concepts into practice

·         -Provide explanations and information to others on difficult issues

·         -Coach, provide feedback, and guide others

·        - Act as a resource for others with less experience

·        - Unrestricted RN license required in state of residence

·        - Minimum 3 years of experience in Managed Care and/or Clinical background

·       -  Intermediate level of experience with Microsoft Excel, Word, Outlook, and Internet

Additional Assets Preferred:

·         -Knowledge of Milliman care guidelines

·         -Pre-authorization experience

·         -Case Management experience

·         -Certified Case Manager (CCM)

·        - Undergraduate degree

Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.

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. In addition, employees in certain positions are subject to random drug testing.