Inpatient Authorization RN - Central Time Zone
About the position 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 Authorization Nurse is responsible for engaging in the collaborative process which assesses, plans, implements, coordinates, monitors and evaluates services to help improve member’s health outcomes. If you have your RN License in the state of LA, or a Compact License from any state in the Central Time Zone you will have the flexibility to work remotely as you take on some tough challenges. 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. Responsibilities • Review and documentation of requests for services via electronic transmittal and/or fax for inpatient services • Processes the initial review for all hospitalized members within assigned facilities • Collaborates with the interdisciplinary care team (ICT) and medical director(s) to facilitate appropriate treatment for members and identify high risk members that will be followed by the care coordinators • Initiates care coordination (Nurse Practitioner, MSW, RN) referrals for members when necessary • Monitors the member’s adherence to the plan of care • Collaborates with the hospital case management staff and facility care providers to review admission and discharge planning • When appropriate, involves and assists member and/or caregiver in continuation of care to the outpatient setting or alternative levels of care Requirements • Current/Active Louisiana Registered Nurse (RN) or Compact License from any state in Central Time Zone • Experience in a clinic/hospital or similar setting • Experience with clinical documentation systems • Experience in assessing members and developing care plans • Computer/typing proficiency to enter/retrieve data in electronic clinical records and documentation systems, experience with email, internet research, use of online calendars and other software applications Nice-to-haves • Bachelor of Nursing • 3+ years of clinical experience in health care and/or managed care • Experience with medical terminology and coding • Working knowledge in Interqual and CMS guidelines • Understanding of healthcare industry • Understanding of nursing home, skilled nursing facility and long-term acute care regulations • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy Benefits • a comprehensive benefits package • incentive and recognition programs • equity stock purchase • 401k contribution Apply tot his job