Utilization Management Nurse 2-Remote, US

Become a part of our caring community and help us put health first
 Full-Time, Remote Telephonic opportunity

As a Utilization Management RN working on the Home Solutions team, you will have the opportunity to use your clinical knowledge, communication skills, and independent critical thinking skills to ensure value-based care for members who desire to heal at home. In this role you will coordinate and communicate with providers, members, or other parties to facilitate optimal member care and treatment.

Shift is Monday - Friday 8:00am - 5:00pm Eastern Standard Time
Business needs may require rotational Evening, Weekends and Holiday coverage (between 8 AM to 8 PM EST)

Responsibilities

-- A secure home-office space, full-time uninterrupted work hours and hard-wired, high-speed internet service is required for this position --

The Utilization Management Nurse 2 helps to ensure fully coordinated care at home for our members. Success in this role requires the following:

Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Excellent organizational and time management skills

Solid analytical skills to understand and interpret data to make recommendations to improve patient care.  

Technical savvy and ability to navigate multiple systems and screens while working cases.

Collaboration skills to effectively interact with multiple parties both internal and external.

An understanding of department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

Ability to make decisions regarding your own work methods, occasionally in ambiguous situations, and with minimal direction receiving guidance where needed.

Ability to follow established guidelines/procedures.

#LI-Remote

Use your skills to make an impact
 

Required Qualifications

Minimum of associate degree in nursing

Licensed Registered Nurse (RN) in a compact state with no disciplinary action.

Must have valid compact license or reside in a compact state and be eligible to upgrade to compact licensure.

Three (3) or more years of progressive clinical experience

Effective telephonic and virtual communication skills

Comprehensive knowledge of Microsoft Word, Outlook and Excel

Ability to work independently under general instructions and within a team.

Work-At-Home Requirements

Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role).

A minimum standard speed for optimal performance is 25mbs download x 10mbs upload is required.

Check your internet speed at www.speedtest.net

A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to …