Experienced NICU Utilization Management Nurse RN – Remote Opportunity for Talented Professionals in Texas or Missouri

Welcome to UnitedHealth Group At UnitedHealth Group, we are driven by a profound passion to improve the health and wellbeing of individuals and communities across the globe. As a leader in the healthcare industry, we leverage cutting-edge technology and innovative approaches to deliver high-quality care that makes a meaningful difference in people's lives. Our organization is built on a foundation of diversity, inclusion, and a commitment to fostering an environment where talented professionals can thrive and grow. If you are a dedicated and compassionate NICU Utilization Management Nurse looking for a challenging and rewarding role, we invite you to join our team and contribute to our mission of advancing health equity on a global scale. About the Role We are seeking an experienced NICU Utilization Management Nurse to join our team in a remote capacity. As a key member of our utilization management team, you will play a vital role in ensuring that our health services are delivered efficiently and effectively. Your expertise and judgment will be essential in assessing and interpreting member needs, identifying solutions that promote healthier lives, and collaborating with interdisciplinary teams to achieve optimal outcomes. This is a unique opportunity to make a lasting impact on the lives of our members and contribute to the evolution of healthcare services. Primary Responsibilities Determine the appropriateness of inpatient services following evaluation of medical guidelines and benefit determination Identify solutions to non-standard requests and problems, demonstrating creativity and critical thinking Translate concepts into practice, applying your knowledge and expertise to real-world scenarios Act as a resource for others, providing explanations and information on difficult issues and mentoring colleagues as needed Requirements and Qualifications To be successful in this role, you will need to possess a unique blend of clinical expertise, technical skills, and personal qualities. The following requirements and qualifications are essential: Essential Qualifications Current, unrestricted compact RN license required in the state of residence (Texas or Missouri) 3+ years of NICU clinical experience, with a deep understanding of neonatal care and utilization management principles Proven ability to demonstrate proficiency in computer skills, including Windows, IM, Excel (Microsoft Suite), Outlook, and clinical platforms Willingness to work weekends and holidays on rotation, with flexibility to adapt to changing schedules and priorities Designated workspace and access to high-speed internet via cable/DSL in home, with a reliable and secure connection Permanent residence in the state of Texas or the state of Missouri, with a strong understanding of local healthcare systems and regulations Ability to work at least every other Saturday on a rotational basis, with a commitment to maintaining a high level of productivity and engagement Preferred Qualifications Certified Case Manager (CCM), with a strong foundation in case management principles and practices Utilization Management experience, with a deep understanding of medical guidelines and benefit determination Case Management experience, with a proven track record of coordinating care and promoting optimal outcomes Knowledge of InterQual Criteria, with the ability to apply this knowledge in real-world scenarios Career Growth and Development At UnitedHealth Group, we are committed to supporting the career growth and development of our employees. As a NICU Utilization Management Nurse, you will have access to a range of training and development opportunities, including: Comprehensive orientation and onboarding program, with a focus on introducing you to our organization and role Ongoing training and education, with a focus on developing your skills and knowledge in utilization management and case management Opportunities for professional certification, with support and resources to help you achieve your career goals Career advancement opportunities, with a focus on promoting from within and developing our employees for future roles Work Environment and Company Culture Our organization is built on a foundation of diversity, inclusion, and respect for all employees. We believe that a positive and supportive work environment is essential for promoting employee engagement, productivity, and job satisfaction. As a NICU Utilization Management Nurse, you will be part of a dynamic and collaborative team, with opportunities to: Work remotely, with flexibility to balance your work and personal life Collaborate with interdisciplinary teams, including clinicians, case managers, and other healthcare professionals Participate in ongoing training and education, with a focus on developing your skills and knowledge Contribute to our organization's mission and values, with a focus on advancing health equity and promoting optimal outcomes Compensation and Benefits We offer a competitive salary and benefits package, with a focus on rewarding and recognizing our employees for their contributions. As a NICU Utilization Management Nurse, you will be eligible for: A competitive salary, with opportunities for advancement and growth Comprehensive benefits package, including medical, dental, and vision coverage 401(k) retirement plan, with a focus on supporting your long-term financial goals Opportunities for professional development and career advancement, with a focus on promoting from within Conclusion If you are a dedicated and compassionate NICU Utilization Management Nurse looking for a challenging and rewarding role, we invite you to join our team at UnitedHealth Group. With a focus on advancing health equity, promoting optimal outcomes, and supporting the career growth and development of our employees, we believe that our organization offers a unique and compelling opportunity for talented professionals. Apply now to take the first step towards a rewarding and challenging career as a NICU Utilization Management Nurse. Apply for this job