Quality Assurance Nurse – Remote

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.

The Quality Assurance Nurse is responsible for supporting corporate objectives and ensures quality health care by providing oversight of appeals and quality of care issues. 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities:

• Work collaboratively with the Chief Medical Officer, Appeals & Grievance Team, Associate Medical Directors and others as necessary to ensure the integrity of medical and clinical decisions
• Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
• Ability to work with minimal guidance; seeks guidance on only the most complex tasks
• Provides input in physical health and behavioral health appeals. Able to review complex information and summarize key points for appeals, indicating necessary review points (page numbers, etc.) for physician review
• Provides nursing input to quality assurance issues, particularly quality of care considerations. Able to present investigations to internal teams to help decide leveling and action plans

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 and unrestricted RN license
• 5+ years of clinical nursing experience
• 2+ years of behavioral health experience
• Experience facilitating presentations
• Intermediate computer skills (Microsoft Word, Excel, Outlook, and Internet) with the ability to navigate a Windows environment
• Ability to work Monday – Friday 8:00 am – 5:00 pm MST

Preferred Qualifications:

• RN license in the state of Colorado
• Previous managed care experience
• Experience working with providers 
• Demonstrated ability to manage multiple projects simultaneously

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

 

The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

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. 

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.     

 

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