RN On-Site Utilization Management Nurse - Wichita, KS at Wichita

Description:

Theres an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isnt 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 lifes best work.(sm)

We are seeking an On-Site Utilization Management Registered Nurse to work on-site at local facilities in Wichita, KS for Inpatient Care Management (ICM).

Work Schedule: Mon- Fri 8:00 am - 5:00 pm & No Weekends

The responsibilities of this position include:

Performs utilization and concurrent review using Milliman criteria
Conducts clinical chart assessments
Discusses cases with treating physicians and other healthcare professionals to better understand plans-of-care
Identifies and evaluate delays in care
Initiates a discharge planning and readmission prevention plan when applicable
Approves bed days for inpatient cases when applicable
Arranges alternative care services; Contact and maintain communication with acute long term care, acute rehabilitation, or skilled nursing facilities to move patients through the care continuum
Gathers clinical information to assess and expedite care needs
Maintains appropriate documentation
Consults with the Medical Director as needed to troubleshoot difficult or complex cases
Participates in telephonic and in-person staff meetings
Develops member centric discharge plan to prevent readmission
Interacting daily with external/internal physicians, case managers, Social workers, family members, and other members of the health care team.

UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.
Together, were removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.

Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.

Qualifications:

Active and unrestricted RN license required in state of KS
3 or more years of inpatient care experience
2 or more years of utilization management, utilization review or case management experience
Advanced level of experience with Microsoft Word, with the ability to navigate a Windows environment
Valid drivers license, current auto insurance and reliable transportation to work within the required local geographical territory
Strong ability to work autonomously and be self-directed
Excellent written and verbal communication skills with the ability to build relationships

Additional Assets Preferred:

Pre-authorization experience
Certified Case Manager (CCM)
Undergraduate degree

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Keywords: inpatient, nurse, clinical, utilization management, utilization review, onsite, registered nurse, Wichita, KS
Country: USA, State: Kansas, City: Wichita, Company: UnitedHealth Group.