NICU Utilization Management RN – Remote in Tennessee

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. 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 NICU Utilization Management Nurse 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?

This position is fully remote and open to candidates in the state of Tennessee, with a current and unrestricted, Compact RN License. This role operates primarily operates primarily Monday-Friday daytime hours, however occasional Saturdays or Sundays may be required on a rotational basis.

If you are located in the state of Tennessee, you will have the flexibility to work remotely* as you take on some tough challenges. 

Primary Responsibilities:

• Determine the appropriateness of inpatient services following evaluation of medical guidelines and benefit determination
• 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 

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. 

Required Qualifications: 

• Current, unrestricted compact RN license required in the state of Tennessee
• 3+ years of NICU Clinical experience
• Proven ability to demonstrate a proficiency in computer skills – Windows, IM, Excel (Microsoft Suite), Outlook, and clinical platforms
• Willing to work weekends and holidays on rotation
• Designated workspace and access to high-speed internet via cable/DSL in home 
• Permanent Residence in the state of Tennessee

Preferred Qualifications:

• Certified Case Manager (CCM)
• Utilization Management experience
• Case Management experience
• Knowledge of InterQual Criteria

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

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.   

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.