There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)

This position requires working until 6 PM Eastern. Residency in the Eastern Time Zone is not required.

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

Primary Responsibilities:

• Manage an assigned caseload which entails assessment, education and coordination of care for members/health care providers throughout the United States telephonically while keeping a detailed medical record within internal database. Establish and maintain regular contact with members, providers and department supervision
• Manage inbound and outbound calls from providers to prior authorize tests and procedures related to members’ certified health conditions and program coverage
• Review medical records (monitoring, treatment and supportive) to determine WTC relatedness for potential program coverage and communicate results to members
• Completion of system generated tasks, including documenting all results as required in internal database (MedNet)
• Prepare comprehensive reviews and summaries for medical appeals, determination of coverages, and requests for treatment services
• Point of contact for internal departments to answer questions relative to members of their assigned caseload
• Completion of medical health questionnaires in times of reduced coverage
  

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:

• Undergraduate degree or equivalent experience
• Active, unrestricted RN license in the State of New York
• 4+ years of clinical experience
• Case management experience
• Experience with Microsoft Office programs
• Access to install secure high-speed internet and a dedicated, distraction-free workspace at home
  

Preferred Qualifications:

• Utilization management experience, including prior authorizations
• Extended care experience
• Discharge planning experience
• Effective interpersonal, communication, and problem-solving skills
• Solid telephone communication skills
• Excellent organizational and multi-tasking abilities
• Ability to work independently as well as on a team
  
  

Careers with LHI . Our focus is simple. We’re innovators in cost-effective health care management. And when you join our team, you’ll be a partner in impacting the lives of our customers, and employees. We’ve joined OptumHealth, part of the UnitedHealth Group family of companies, and our mission is to help the health system work better for everyone. We’re located on the banks of the beautiful Mississippi River in La Crosse, Wis., with a satellite office in Chicago and remote employees throughout the United States. We’re supported by a national network of more than 25,000 medical and dental providers. Simply put, together we work toward a healthier tomorrow for everyone. Our team members are selected for their dedication and mission-driven focus. For you, that means one incredible team and a singular opportunity to do your life’s best work.(sm)

Colorado, Connecticut, Nevada, or New York City Residents Only : The hourly range for Colorado residents is $26.15 to $46.63. The hourly range for Connecticut/Nevada/New York City residents is $28.85 to $51.30. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

*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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment