UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)
The Senior Clinical Admin Nurse will be responsible for providing individualized attention to UMR membership and covered families and serves to assist with navigation of the health care system. The purpose of the clinical liaison nurse is to help individuals live their lives to the fullest by supporting coordination and collaboration with multiple and external partners including consumers and their families/caregivers, medical, and other clinical teams.
If you are located in Columbia, TN, you will have the flexibility to telecommute* as you take on some tough challenges.
Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost efficiently
Assist members with locating appropriate providers
Teach members how to navigate UMR internet-based wellness tools and resources
Outreach to membership providing pre-admission counseling to membership
Outreach to membership providing discharge planning to membership and caretakers
Track all activities and provide complete documentation to generate customer reporting
Accept referrals via designated processes, collaborate in evaluating available services, and coordinate necessary medical care and community referrals as needed
Comply with all policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases
Contribute to treatment plan discussions
Other duties as assigned
Candidate must be willing to work Monday - Friday 8:00 am - 5:00 pm.
Competencies, Knowledge, Skills, and Abilities:
Demonstrates an ability to develop creative solutions and problem solving
Proactive- does not wait for things to happen
Evidence of ability and willingness to learn and adapt to frequent changes to workflows, processes and procedures resulting from new technology, customer demands, competitive pressures, etc.
Proven ability to adapt quickly to unique situations and make decisions
Demonstrates initiative and proactivity in dealing with issues and driving them to conclusion
Excellent communication skills, both oral and written, demonstrated by an ability to coordinate and communicate across functional departments, and with external contacts
Evidence of ability to work independently and to plan, organize, and accomplish assignments in a timely and credible manner
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.
Bachelor’s degree in registered nursing or equivalent experience
Active RN license in state of residence
Compact state license
2+ years of managed care experience
Utilization management experience
Ability and flexibility to assume responsibilities and tasks in a constantly changing work environment
Able to function independently and responsibly with minimal supervision
Excellent customer service orientation
Proven team player and team building skills
Demonstrated excellent verbal and written communication skills
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.