Utilization Management RN

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Anthony S.
Dragon Boat Racer
Utilization Management Nurse

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Utilization Management RN

We're not just out to help people lead healthier lives. We also are working hard to help make health care work better for everyone. This role has a major impact on that goal.  You'll work on a multidisciplinary team to help ensure that care settings of members meet their specific needs, co-manage member outcomes, reduce hospital bed days, provide discharge planning assistance and make referrals to other services when necessary.

Latest Utilization Management RN Jobs

Nurse Associate (USRN Academy) - Taguig City, NCR (732366)

Full-time Taguig City, Philippines

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Region: Asia Pacific Country Philippines
State/Province: 00 City: Taguig City
Position Description
Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Due to our expanding business, Optum, part of the UnitedHealth Group family of businesses is seeking Clinical Administrative Coordinators who share our passion for helping others live healthier lives. As one of the world's leading health care companies, Optum is pursuing innovative new ways to operate our service centers and improve on our ability to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to ma...

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Clinical Investigator (721301)

Full-time Hyderabad, India

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Clinical Investigator
Posted 9/14/2017
Region: Asia Pacific Country India
State/Province: TS City: Hyderabad
Position Description
Purpose of Job:   This process works on identifying discrepancies between medical records and billed services for complex and high value claims by identifying Up-coding, Unbundling, Duplication, and Misrepresentation of services. They approve/deny claims & Identify provider aberrant behavior patterns. The associates prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT/ diagnosis codes, CMC guideline along with referring to client specific guidelines and member policies Responsibilities:   Prevent the payment of potentially fraudulen...

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Neonatal Case Management Nurse - Taguig City, NCR (715214)

Full-time Taguig City, Philippines

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Region: Asia Pacific Country Philippines
State/Province: 00 City: Taguig City
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Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Due to our expanding business, Optum, part of the UnitedHealth Group family of businesses is seeking Clinical Administrative Coordinators who share our passion for helping others live healthier lives. As one of the world's leading health care companies, Optum is pursuing innovative new ways to operate our service centers and improve on our ability to deliver high-quality care. As part of our clinical support team, you will be a key component in customer satisfaction and have a responsibility to m...

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Clinical Investigator DRG - Taguig City, NCR (711453)

Full-time Taguig City, Philippines

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Region: Asia Pacific Country Philippines
State/Province: 00 City: Taguig City
Position Description
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

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Clinical Coverage Review Nurse - E&I - Quezon City, NCR (708150)

Full-time Quezon City, Philippines

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Region: Asia Pacific Country Philippines
State/Province: 00 City: Quezon City
Position Description
Talk about meaningful work. Talk about an important role. Let's talk about your next career move. Due to our expanding business, Optum, part of the UnitedHealth Group family of businesses is seeking Clinical Administrative Coordinators who share our passion for helping others live healthier lives. As one of the world's leading health care companies, Optum, part of the UnitedHealth Group family of businesses is pursuing innovative new ways to operate our service centers and improve on our ability to deliver high-quality care. As part of our clinical support team, you will be a key component in...

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