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Registered Nurse In The ICU jobs at Tenet Healthcare

- 150 jobs
  • Registered Nurse (RN) - ICU

    Tenet Healthcare 4.5company rating

    Registered nurse in the icu job at Tenet Healthcare

    Under minimal supervision, provides nursing care for a group of patients assigned to the nurse based on matching the patients' needs with the nurse' competencies. Completes established competencies for the position within designated introductory period. Other related duties as assigned. MINIMUM EDUCATION: Graduate of accredited school of nursing. PREFERRED EDUCATION: Bachelor's Degree MINIMUM EXPERIENCE: None PREFERRED EXPERIENCE: Two years in acute care. Previous clinical nursing experience in med/surg, telemetry or ICU REQUIRED CERTIFICATIONS/LICENSURE: Possession of current Texas State License for Registered Nurse REQUIRED COURSES/COMPLETIONS (e.g., CPR): Must have active healthcare provider Basic Life Support on hire (ARC or AHA); however, must have AHA Healthcare Provider BLS within 60 days of hire. AHA ACLS must be completed within 60 days of hire or transfer into role (ADULT CRITICAL CARE, TELEMETRY, INTERIM CRITICAL CARE UNITS). *Should be completed before the end of the orientation period AHA PALS must be completed within 60 days of hire or transfer into role (PEDI ICU) *Should be completed before the end of the orientation period AHA NRP must be completed within 60 days of hire or transfer into role (NICU). S.T.A.B.L.E. for NICU- Level 2 Nursery-Must provide proof of prior completion or obtain within 6 months of hire or transfer date into unit (Renewal is not required). #LI-AP1
    $91k-118k yearly est. Auto-Apply 40d ago
  • TRA Telemetry RN Travel and Local Contracts

    Tenet Healthcare 4.5company rating

    Registered nurse in the icu job at Tenet Healthcare

    RN Tele Travel and Local Contracts This role provides direct clinical patient care with Tenet's in-house contingent Pool, Trusted Resource Associates. Work directly with Tenet on a Travel Contract, Local Contract or PRN. With this in-house assignment you will be part of the contingent workforce pool, yet, a W-2 Tenet employee and wear a Tenet employee badge so you blend in as staff and are not outstanding as a Contractor. You will have direct access to Tenet's hiring managers and, if you ever turn permanent at a Tenet hospital, you will have built up tenure. *For a faster reply, email your resume: ******************************* Job Description and Requirements Specialty: Tele Discipline: RN Start Date: ASAP Duration: 13 Weeks 36 Hours per week Shift: 12 Hours Night Employment Type: Travel Contract and Local Contracts TRA RN Tele: The Registered Nurse will assume responsibility for assessing, planning, implementing direct clinical care to assigned patients on a per shift basis, and unit level. The role is responsible for supervision of staff to which appropriate care is delegated. The role is accountable to support facility CNO to ensure high quality, safe and appropriate nursing care, competency of clinical staff, and appropriate resource management related to patient care. Requirements: - BLS, ACLS, and CPI required for Tele - Must have 2 years of nursing experience with a minimum one-year current experience in your specialty Benefits Weekly pay Housing and Per Diem stipend for Travel Contracts Guaranteed Hours (For Travel Contracts) Preferred Booking Agreement (for Local Contacts) Referral bonus (TRA Active Employees) Education: Required: Graduate of an accredited school of nursing. Preferred: Bachelor's or master's degree. Experience: Required: 2 years of current experience in their specialty. Certifications: Required: Currently licensed, certified, or registered to practice profession as required by law, regulation in state of practice or policy; AHA BLS, and if applicable by corporate policy for unit of hire, AHA ACLS and/or PALS and/or NRP. Physical Demands:
    $92k-117k yearly est. Auto-Apply 9d ago
  • Licensed Vocational Nurse/LVN - Heart & Vascular Specialists Clinic - Full-Time, Days

    Texas Health Resources 4.4company rating

    Remote

    Licensed Vocational Nurse/LVN - Heart & Vascular Specialists Clinic - Full-Time, Days - (25011364) Description Licensed Vocational Nurse/LVN - Heart & Vascular Specialists Clinic - Full-Time, DaysBring your passion to Texas Health so we are Better + Together Work location: Alliance - 10840 Texas Health Trail, Alliance/Keller, TX 76244Work hours: Full-time, 40 hours weekly, Monday thru Friday, 8:00am - 5:00pmTravel: 25% to surrounding clinics as needed (mileage reimbursement provided) Heart & Vascular Specialists Clinic Highlights:Strong teamwork and collaboration Fast-paced, high volume inbound/outbound calls Compassion and empathy to our patients and the TeamJoin an innovative team working towards making healthcare more accessible, integrated, and reliable Qualifications Here's What You NeedLVN - Licensed Vocational Nurse Upon Hire (required) Accredited School of Practical Nursing Program (required)6 months LVN experience (strongly preferred)1 year LVN experience (preferred) Proficient IV insertion and ECG rhythms experience (strongly preferred) ACLS or BCLS (required upon hire) Knowledge of basic nursing processes and understanding of healthcare technology, equipment, and supplies Knowledge of state law on nursing care, nurse practice guidelines, and clinic policies and procedures Ability to effectively communicate to staff and patients Demonstrate sound judgment and composure Ability to take appropriate action in questionable or emergency situations Maintain a positive, caring attitude towards staff and patients Possess a strong work ethic and a high level of professionalism Efficient time management skills What You Will DoDelivers care to patients utilizing the LVN ProcessPerforms basic nursing care for patients by following established standards and procedures. May perform specific nursing care as it relates to specialty of the practice. Collects patient data such as vital signs, notes how the patient looks and acts or responds to stimuli and reports this information accordingly. Prepares and administers injections, performs routine tests, treats wounds and changes bandages. 10%Prepares patient records and files using established medical record forms/automated systems and documentation practices. Administers certain prescribed medications and monitors and documents treatment progress and patient response. Participates in the implementation and evaluation of patient care based on practice guidelines, standards of care, and federal/state laws and regulations. Monitors and documents treatment progress and patient response. Conveys information to patients and families about health status, health maintenance, and management of acute and chronic conditions. Participates in teams to improve patient care processes and outcomes. Performs other duties as assigned. Additional perks of being a Texas Health employee Benefits include 401k, PTO, medical, dental, Paid Parental Leave, flex spending, tuition reimbursement, Student Loan Repayment Program as well as several other benefits. Delivery of high quality of patient care through nursing education, nursing research and innovations in nursing practice. Strong Unit Based Council (UBC). A supportive, team environment with outstanding opportunities for growth. Learn more about our culture, benefits, and recent awards. Entity Highlights:Texas Health Physicians Group includes more than 1,000 physicians, nurse practitioners and physician assistants dedicated to providing quality, patient-safe care at more than 240 offices located throughout the DFW Metroplex. THPG members are active in group governance and serve on multiple committees and councils. Ongoing Texas Health initiatives, like the Diversity Action Council and Living the Promise, have helped to create an inclusive, supportive, people-first, excellence-driven culture and workplace, making THPG a great place to work. If you're ready to join us in our mission to improve the health of our community, then let's show the world how we're even better together! Do you still have questions or concerns? Feel free to email your questions to recruitment@texashealth. org. #LI-CT1 Primary Location: AllianceOther Locations: Pecan Acres, Decatur, Dish, Northlake, Highland Village, Krum, Newark, Argyle, Haslet, Saginaw, Copper Canyon, Blue Mound, Rhome, Denton, Corral City, Flower Mound, Justin, Trophy Club, Roanoke, Westlake, Watauga, KellerJob: LVNOrganization: Texas Health Physicians Group 9250 Amberton Parkway TX 75243Travel: Yes, 25 % of the TimeJob Posting: Nov 3, 2025, 5:43:32 AMShift: Day JobEmployee Status: RegularJob Type: StandardSchedule: Full-time
    $39k-53k yearly est. Auto-Apply 17h ago
  • Registered Nurse (RN) - Transfer Coordinator - Mid Shift

    Community Health Systems 4.5company rating

    Remote

    The Transfer Coordinator - RN is responsible for coordinating patient transfers and admissions into and out of CHS facilities. This role performs initial admission screening using approved clinical criteria, ensuring each transfer aligns with policy and clinical standards. The Transfer Coordinator works closely with the Bed/Capacity Coordinator, hospital departments, and external healthcare providers to facilitate efficient patient flow and address barriers to patient throughput. Essential Functions Coordinates all aspects of patient transfers, admissions, or consultations from referring facilities, ensuring appropriate level of care and transport. Conducts admission screening using approved criteria to verify appropriateness of care level and bed assignments. Collaborates with Bed/Capacity Coordinator to prioritize transfers, bed assignments, and ensure patient information accuracy. Acts as a liaison between physicians, healthcare providers, patients, and families to streamline the admission/transfer process. Maintains and updates the Electronic Health Record (EHR) with accurate patient transfer information and outcomes. Identifies barriers to patient throughput, tracks trends, and recommends actions to improve efficiency and patient flow. Complies with regulatory and CHS policy standards, including EMTALA and quality initiatives, while adapting processes to ensure compliance. Utilizes medical necessity criteria to evaluate admissions, ensuring bed types and patient statuses are appropriate. Builds and maintains collaborative relationships with hospital staff, nursing units, and external healthcare providers to support quality patient care. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications Associate Degree in Nursing required Bachelor's Degree in Nursing preferred 1-3 years of clinical nursing experience in an acute care setting required Prior experience in transfer coordination or patient flow in ED or Critical Care preferred Knowledge, Skills and Abilities Strong clinical assessment and decision-making skills for managing patient transfers. Knowledge of healthcare regulations, including EMTALA and medical necessity guidelines. Excellent communication skills and ability to work effectively with multidisciplinary teams. Strong organizational skills with the ability to prioritize multiple tasks in a dynamic environment. Proficient in using electronic health record systems and standard office software. Ability to provide superior customer service and facilitate positive patient experiences. Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure in the state of Tennessee required
    $11k-57k yearly est. Auto-Apply 46d ago
  • RN- Surgery Full Time

    Community Health Systems 4.5company rating

    Remote

    The Registered Nurse (RN) provides patient-centered care through the nursing process of assessment, diagnosis, planning, implementation, and evaluation. This role is responsible for coordinating and delivering high-quality care based on established clinical protocols and physician/provider orders. The RN collaborates with physicians, nurses, and other healthcare professionals to ensure effective patient care and desired outcomes, while maintaining a supportive and compassionate environment for patients and their families. Essential Functions Coordinates and delivers high-quality, patient-centered care in accordance with organizational policies, protocols, and the nursing process. Conducts thorough patient assessments and documents findings accurately, reporting changes in condition to the appropriate care team members. Utilizes knowledge of human growth and development to provide age-appropriate care and education. Administers prescribed medications, monitors for side effects, and documents administration in accordance with standards of practice. Assists physicians during procedures within the scope of documented competency and skill level. Collaborates with the healthcare team to develop, implement, and evaluate individualized care plans based on patient assessments and needs. Responds to medical emergencies and participates in life-saving interventions, such as CPR and code team activities, as appropriate. Advocates for the rights and needs of patients, ensuring their voices are heard and respected in care planning and delivery. Provides patient and family education on medical conditions, treatment plans, and post-discharge care, ensuring understanding and adherence to instructions. Implements and adheres to infection control protocols to prevent the spread of healthcare-associated infections. Monitors and operates medical equipment (e.g., IV pumps, monitors, ventilators) as needed for patient care and safety. Promotes patient safety by adhering to National Patient Safety Goals and maintaining a clean, safe environment for patients and staff. Participates in audits, chart reviews, and compliance checks to ensure adherence to standards of practice and regulatory requirements. Demonstrates responsible decision-making in planning, delegating, and providing care based on patient needs and organizational policies. Documents patient care and education thoroughly and promptly in the medical record. Engages in professional development to maintain clinical competency and understanding of current nursing standards and regulations. Participates in performance improvement initiatives, including data collection and process development, to enhance patient outcomes and care delivery. Critical Care RN: Administers medications and other treatments as prescribed, including intravenous medications and therapies. Manages complex medical equipment, including ventilators, monitoring devices, and other life-support systems. Performs procedures such as inserting central lines, managing tracheostomies, and providing advanced cardiac life support. Emergency Services RN: Rapid Assessment and Triage: Evaluate patients' conditions quickly to determine the severity of their injuries or illnesses and prioritize care accordingly. Conducts emergency procedures such as intubation, wound care, and suturing. Implements interventions to stabilize patients, including administering medications, starting IV lines, and providing respiratory support. OR Services RN: Provides comprehensive care to patients before, during, and after surgery, including assessments, planning, and evaluation of nursing care. Scrubs in for surgeries, assisting the surgical team with instruments and supplies, and ensuring a sterile environment. Monitors patient vital signs, administers medications, and observes for changes in patient condition. Cardiac Surgery RN: Continuously assesses patients' condition, including vital signs, hemodynamic parameters, and ECG readings. Administers medications and IV drips, adjusting dosages based on the patient's condition. Proficient in operating and maintaining advanced life support equipment like ventilators, intra-aortic balloon pumps, and ECMO. After cardiac surgeries, monitors patients' recovery, manage chest tubes, pacing wires, and wound care. Endoscopy RN: Assesses patient needs, reviews medical history, explains procedures, obtains consent, and prepares the patient for procedure. Monitors patient vitals, administers medications, and assists the physician during procedure. Provides post-procedure care, monitors recovery, and educates patients about aftercare instructions. Ensures the endoscopy room is properly prepared, instruments are sterilized, and equipment is functioning correctly. Obstetrics/Labor and Delivery/Post Partum/Nursery RN: Educates patients about pregnancy, provides prenatal screenings, and prepares patients for labor and delivery. Assesses and monitors the new mother's physical recovery, including vital signs, postpartum hemorrhage, and potential complications like postpartum depression. Assists with epidurals and other pain management techniques during labor. Administers pain medication, induces labor, and manages other medication needs during labor and delivery. Assists during labor and delivery, monitors fetal well-being, administers medications, and provides pain relief. Monitors mothers and newborns after delivery, assessing their well-being, and providing education on postpartum care and breastfeeding. Assesses and monitors newborn health, taking vital signs, performing routine assessments, and educating parents on newborn care. Assists with gynecological exams and procedures, and provides education on reproductive health, contraception, and prenatal care. Educates patients about family planning, fertility, pregnancy, childbirth, and postpartum care. Interprets fetal heart rate patterns and assesses fetal well-being using electronic fetal monitoring. Oncology RN: Administers chemotherapy, manages side effects, monitors vitals, and manages pain. Explains treatments, answers questions, and provides information on resources. Provides emotional and psychological support to patients and their families. Orthopedics RN: Provides specialized care for patients with musculoskeletal conditions, injuries, and diseases. Provides care for Orthopedic patients encompassing pre-operative and post-operative care. Conducts peripheral/vascular assessments. Treats patients with immobilization devices. Provides pain management. Provides patient education. PACU RN: Assesses the patient's level of consciousness and responsiveness as they wake up from anesthesia. Evaluates pain levels and administers pain medications as prescribed. Observes any side effects of anesthesia, such as nausea, vomiting, shivering, or muscle aches. Monitors for and respond to any post-operative complications. Administers medications, including pain relievers and other post-operative medications, as prescribed. Regulates intravenous (IV) fluids and monitor fluid balance. Checks and changes dressings on surgical wounds. Ensures a clear airway and provide oxygen support as needed. Educates patients and families about post-surgery care, potential complications, and discharge instructions. NICU RN: Continuously assesses and monitors vital signs (heart rate, respiratory rate, blood pressure, oxygen saturation) and other signs of distress. Administers prescribed medications, intravenous fluids, and other treatments, including respiratory support and oxygen therapy. Manages feeding needs, including tube, breast milk feeding support, and ensuring adequate nutrition. Provides basic care tasks like diaper changes, bathing, and positioning. Performs procedures like inserting IV lines, administering medications, and assisting with intubation or ventilation. Operates and adjusts specialized medical equipment used in the NICU. Telemetry RN: Using telemetry equipment to track heart rhythms (EKG), blood pressure, oxygen saturation, and other vital signs. Analyzes telemetry data to identify trends, abnormalities, and potential problems, and reports these findings to physicians. Provides direct patient care, including medication administration, wound care, and patient education, with a focus on cardiac health. Recognizes and responds to emergencies, such as cardiac arrest, and implements appropriate interventions. Dialysis RN: Sets up and operates dialysis machines, monitors patients before, during, and after treatment, and adjusts treatment parameters as needed. Takes vital signs, monitors signs of complications, and responds to changes in patient condition. Educates patients and families about kidney disease, dialysis procedures, and the importance of adhering to treatment plans, diet, and medication. Inspects and maintains dialysis machines and equipment. Cath Lab RN: Pre-Procedure: Reviews medical history, assesses patient's overall health, and prepares them for the procedure. Intravenous (IV) Line Initiation: Starts and maintains an IV line for medication administration. Administers medications as prescribed by the physician. Educates patients and families about the procedure and what to expect. Verifies that surgical consents have been signed. During the Procedure: Assists the Cardiologist during the catheterization process. Closely monitors the patient's vital signs, hemodynamic data, and sedation levels. Ensures proper functioning of equipment and supplies. Manages potential complications and responding to emergencies. Post-Procedure: Continues to monitor the patient's vital signs and overall condition after the procedure. Administers post-procedure medications as needed. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards. Qualifications 0-2 years of experience in a clinical nursing role or student clinical rotations in an acute care setting required Knowledge, Skills and Abilities Strong knowledge of the nursing process and clinical nursing practices. Ability to perform thorough patient assessments and communicate findings effectively. Proficient in administering medications and monitoring for side effects. Effective communication and interpersonal skills to collaborate with interdisciplinary teams. Strong organizational skills and attention to detail in documenting patient care. Knowledge of safety standards, infection control, and quality improvement initiatives. Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure required BCLS - Basic Life Support required ACLS - Advanced Cardiac Life Support preferred PALS - Pediatric Advanced Life Support preferred NRP - Neonatal Resuscitation preferred Refer to facility or unit-specific guidelines for additional requirements.
    $11k-57k yearly est. Auto-Apply 9d ago
  • DRG CVA RN Auditor - National Remote

    Unitedhealth Group 4.6company rating

    Plymouth, MN jobs

    **$10,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS** Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together** . In this position as a **Coding & Clinical Auditor / DRG Specialist RN** , you will apply your expert knowledge of the MS-DRG and APR-DRG coding/reimbursement methodology systems, ICD-10 Official Coding Guidelines, and AHA Coding Clinic Guidelines in the auditing of inpatient claims. Employing both industry and Optum proprietary tools, you will validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses billed by hospitals to identify overpayments. Utilizing excellent communications skills, you will compose rationales supporting your audit findings. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Conduct MS-DRG and APR-DRG coding reviews to verify the accuracy of DRG assignment and reimbursement with a focus on overpayment identification + Utilize expert knowledge to identify the ICD-10-CM/PCS code assignment, appropriate code sequencing, present on admission (POA) assignment, and discharge disposition, in accordance with CMS requirements, ICD-10 Official Guidelines for Coding and Reporting, and AHA Coding Clinic guidance + Apply current ICD-10 Official Coding Guidelines and AHA Coding Clinic citations and demonstrate working knowledge of clinical criteria documentation requirements used to successfully substantiate code assignments + Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding and billing + Utilize solid command of anatomy and physiology, diagnostic procedures, and surgical operations developed from specialized training and extensive experience with ICD-10-PCS code assignment + Write clear, accurate and concise rationales in support of findings using ICD-10 CM/PCS Official Coding Guidelines, and AHA Coding Clinics + Utilize proprietary workflow systems and encoder tool efficiently and accurately to make audit determinations, generate audit rationales and move claims through workflow process correctly + Demonstrate knowledge of and compliance with changes and updates to coding guidelines, reimbursement trends, and client processes and requirements + Maintain and manage daily case review assignments, with a high emphasis on quality + Provide clinical support and expertise to the other investigative and analytical areas + Work in a high-volume production environment that is matrix driven **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* 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:** + Associate's Degree (or higher) + Unrestricted RN (Registered Nurse) license + CCS/CIC or willing to obtain certification within 6 months of hire + 3+ years of MS DRG/APR DRG coding experience in a hospital environment with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies + 2+ years of ICD-10-CM coding experience including but not limited to: expert knowledge of principal diagnosis selection, complications/comorbidities (CCs) and major complications/comorbidities (MCCs), and conditions that impact severity of illness (SOI) and risk of mortality (ROM) + 2+ years of ICD-10-PCS coding experience including but not limited to: expert knowledge of the structural components of PCS such as selection of appropriate body systems, root operations, body parts, approaches, devices, and qualifiers **Preferred Qualifications:** + Experience with prior DRG concurrent and/or retrospective overpayment identification audits + Experience with readmission reviews of claims + Experience with DRG encoder tools (ex. 3M) + Experience using Microsoft Excel with the ability to create / edit spreadsheets, use sort / filter function, and perform data entry + Healthcare claims experience + Managed care experience + Knowledge of health insurance business, industry terminology, and regulatory guidelines **Soft Skills:** + Ability to use a Windows PC with the ability to utilize multiple applications at the same time + Demonstrate excellent written and verbal communication skills, solid analytical skills, and attention to detail + Ability to work independently in a remote environment and deliver exceptional results + Excellent time management and work prioritization skills **Physical Requirements and Work Environment:** + Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer + Have a secluded office area in which to perform job duties during the work day + Have reliable high - speed internet access and a work environment free from distractions *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $34.42 to $67.60 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _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: 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._ \#RPO #GREEN #RPOLinkedin
    $34.4-67.6 hourly 60d+ ago
  • Behavioral Health Registered Nurse FT Weekends!

    Kindred Healthcare 4.1company rating

    Dayton, OH jobs

    Behavioral Health Registered Nurse FT Weekends! (Job Number: 548843) Description $15K SOB!At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job SummaryProvides planning and delivery of direct and indirect patient care through the nursing process of assessment planning, intervention, and evaluation. Develops nursing care plan in coordination with patient, family, and interdisciplinary staff as necessary. Communicates changes in patient's clinical condition with physicians, nursing supervisor/manager, and co-workers as appropriate. Participates in discharge planning process. Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the JD KBHS RN the team Administer medication utilizing the five rights of medication administration reducing the potential for medication errors Assesses and reassess pain. Utilizes appropriate pain management techniques Educates the patient and family regarding pain management Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan of effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient's age. Receives physician's orders, ensures transcription is accurate and documents completion. Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments, and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to the level of licensure Treats patients and their families with respect and dignity Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group. Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients' condition Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs Provides end of shift report to on coming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Performs other duties as requested Knowledge/Skills/Abilities/ExpectationsExcellent oral and written communication and interpersonal skills Knowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0%Must read, write and speak fluent EnglishMust have good and regular attendance Performs other related duties as assigned Qualifications EducationGraduation from an accredited Bachelor of Science in Nursing, Associate Degree in Nursing, or Nursing Diploma program Licenses/CertificationsCurrent state licensure as Registered NurseACLS preferred BCLS certification Crisis prevention training and certification strongly preferred; mandatory completion within 90 days of hire ExperienceMinimum one year in an inpatient psychiatric setting Job: Behavior/Mental HealthPrimary Location: OH-Dayton-Kindred Dayton BHUOrganization: 4020 - Kindred Dayton BHUShift: Weekend
    $50k-67k yearly est. Auto-Apply 7d ago
  • Registered Nurse FT Days!

    Kindred Healthcare 4.1company rating

    Dayton, OH jobs

    Registered Nurse FT Days! (Job Number: 549045) Description $15K SOB!At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job SummaryProvides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and Evaluation. Develops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary. Communicates changes in patient's clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate. Participates in discharge planning process. Essential FunctionsMaintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, provides and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team Assesses and reassesses pain Utilizes appropriate pain management techniques Educates the patient and family regarding pain management. Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan daily for effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient's age Receives physician's orders, ensures transcription is accurate and documents completion Administers medication utilizing the five rights of medication administration reducing the potential for medication errors Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to level of licensure Treats patients and their families with respect and dignity Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients' condition Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Knowledge/Skills/Abilities/ExpectationsKnowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0%Must read, write and speak fluent EnglishMust have good and regular attendance Performs other related duties as assigned Qualifications EducationGraduation from an accredited Bachelor of Science in NursingAssociate Degree in Nursing or Nursing Diploma program Licenses/CertificationCurrent state licensure as Registered NurseBCLS certification required ACLS certifications preferred ExperienceMinimum six months' Medical/Surgical experience in an acute care setting preferred Job: RNPrimary Location: OH-Dayton-Kindred Hospital - DaytonOrganization: 4500 - Kindred Hospital - DaytonShift: Day
    $59k-80k yearly est. Auto-Apply 7d ago
  • Call Center Nurse RN - Part Time - Remote

    Unitedhealth Group Inc. 4.6company rating

    Fort Pierce, FL jobs

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Call Center Nurse RN is responsible for providing comprehensive clinical services to our customers located throughout the U.S. and may require multiple licenses to practice across various states. Services provided to our customers include but are not limited to the following telephonic services: clinical triage, transitions of care, medication adherence and reconciliation, management of gaps in care, and other care extension services. The Call Center Nurse assists and guides patients toward self-management and behavior modifications that result in improved patient outcomes. The Call Center Nurse is the primary point of contact for multiple disciplines. Success is measured in terms of improved patient outcomes, prevention of patient adverse events and satisfied customers, meeting or exceeding quality measures, producing consistent and high-quality work, and collaboration with other care team members. The Call Center Nurse is an experience nurse, able to perform tasks independently and once trained, without guidance. This person can provide education to patients, deploying best practices and standard workflow in their daily activities with the ability to apply their expertise across the various areas of responsibility, understanding how their interactions with patients affect customer satisfaction and can make recommendations to improve processes. Positions in this family require a current, unrestricted nursing license (RN) in the applicable state, as indicated in the function description and/or title. This is a PART TIME position working 7:30am - 6pm Eastern 2 days per week - either Mon and Friday OR Wednesday and Thursday. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Provide remote telephonic nursing support to patients, caregivers, and healthcare providers * Assess and triage patient calls to determine urgency of medical needs * Offer medical advice, guidance, and education to patients and caregivers regarding treatment plans, medication management, and self-care techniques * Collaborate with healthcare professionals to coordinate patient care and follow-up * Document patient interactions, assessments, and recommendations accurately and timely in electronic health records systems * Adhere to established protocols, guidelines, and best practices for telephonic nursing * Maintain patient confidentiality and privacy in accordance with HIPPA regulations * Participate in ongoing training and professional development activities to stay updated on medical advancements and best practices in telehealth * Contribute to quality improvement initiatives to enhance the delivery of telephonic nursing services * Provide exceptional customer service and support to ensure a positive experience for patients and clients * Ability to adapt nursing interventions and care plans to meet the individualized needs and preferences of diverse patients across the continuum of care * Demonstrates the ability to meet deadlines independently and efficiently, requiring minimal to no supervision * Actively engage in collaborative efforts within nursing team to ensure seamless communication, shared knowledge, and coordinated patient care delivery * Utilizes extensive expertise in chronic illnesses and medication management to effectively treat diseases * Works with supervisors to solve more complex problems 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: * Registered Nurse (RN) with a current, active, and unrestricted RN License in PA (state specific or compact) * 3+ years of clinical nursing experience * Experience with electronic medical records system(s) * Proven proficiency using MS Office Suite (i.e. Teams, Outlook, Word, Excel) * Ability to work PT hours (7:30am - 6PM EST) on either Monday and Friday OR Wednesday and Thursday Preferred Qualifications: * Telehealth nursing experience * Experience with Cerner * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. The hourly range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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: 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.
    $28.6-56.1 hourly 60d+ ago
  • Call Center Nurse RN - Part Time - Remote

    Unitedhealth Group 4.6company rating

    Fort Pierce, FL jobs

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** The Call Center Nurse RN is responsible for providing comprehensive clinical services to our customers located throughout the U.S. and may require multiple licenses to practice across various states. Services provided to our customers include but are not limited to the following telephonic services: clinical triage, transitions of care, medication adherence and reconciliation, management of gaps in care, and other care extension services. The Call Center Nurse assists and guides patients toward self-management and behavior modifications that result in improved patient outcomes. The Call Center Nurse is the primary point of contact for multiple disciplines. Success is measured in terms of improved patient outcomes, prevention of patient adverse events and satisfied customers, meeting or exceeding quality measures, producing consistent and high-quality work, and collaboration with other care team members. The Call Center Nurse is an experience nurse, able to perform tasks independently and once trained, without guidance. This person can provide education to patients, deploying best practices and standard workflow in their daily activities with the ability to apply their expertise across the various areas of responsibility, understanding how their interactions with patients affect customer satisfaction and can make recommendations to improve processes. Positions in this family require a current, unrestricted nursing license (RN) in the applicable state, as indicated in the function description and/or title. This is a PART TIME position working 7:30am - 6pm Eastern 2 days per week - either Mon and Friday OR Wednesday and Thursday. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Provide remote telephonic nursing support to patients, caregivers, and healthcare providers + Assess and triage patient calls to determine urgency of medical needs + Offer medical advice, guidance, and education to patients and caregivers regarding treatment plans, medication management, and self-care techniques + Collaborate with healthcare professionals to coordinate patient care and follow-up + Document patient interactions, assessments, and recommendations accurately and timely in electronic health records systems + Adhere to established protocols, guidelines, and best practices for telephonic nursing + Maintain patient confidentiality and privacy in accordance with HIPPA regulations + Participate in ongoing training and professional development activities to stay updated on medical advancements and best practices in telehealth + Contribute to quality improvement initiatives to enhance the delivery of telephonic nursing services + Provide exceptional customer service and support to ensure a positive experience for patients and clients + Ability to adapt nursing interventions and care plans to meet the individualized needs and preferences of diverse patients across the continuum of care + Demonstrates the ability to meet deadlines independently and efficiently, requiring minimal to no supervision + Actively engage in collaborative efforts within nursing team to ensure seamless communication, shared knowledge, and coordinated patient care delivery + Utilizes extensive expertise in chronic illnesses and medication management to effectively treat diseases + Works with supervisors to solve more complex problems 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:** + Registered Nurse (RN) with a current, active, and unrestricted RN License in PA (state specific or compact) + 3+ years of clinical nursing experience + Experience with electronic medical records system(s) + Proven proficiency using MS Office Suite (i.e. Teams, Outlook, Word, Excel) + Ability to work PT hours (7:30am - 6PM EST) on either Monday and Friday OR Wednesday and Thursday **Preferred Qualifications:** + Telehealth nursing experience + Experience with Cerner *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. The hourly range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _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: 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._
    $28.6-56.1 hourly 60d+ ago
  • Registered Nurse/FT/Nights

    Kindred Healthcare 4.1company rating

    Lima, OH jobs

    Registered Nurse/FT/Nights (Job Number: 550111) Description At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Provides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and Evaluation. Develops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary. Communicates changes in patient's clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate. Participates in discharge planning process. Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department. Directs, supervises, provides and evaluates nursing care provided to patients. Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated. Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications. Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies. Performs assessment on all patients on admission and reassessments as per policy. Makes referrals to other disciplines based on assessment. Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team. Assesses and reassesses pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management. Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan daily for effectiveness. Performs patient care responsibilities considering needs specific to the standard of care for patient's age. Receives physician's orders, ensures transcription is accurate and documents completion. Administers medication utilizing the five rights of medication administration reducing the potential for medication errors. Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate. Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice. Performs treatments and provides services to level of licensure. Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families. Functions as liaison between administration, patients, physicians, and other healthcare providers. Interacts professionally with patient/family and involves patient/family in the formation of the plan of care. Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group. Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors. Initiates or assists with emergency measures for sudden adverse developments in patients' condition. Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate. Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs. Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off. Communicates appropriately and clearly to management, co-workers, and physicians. Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs. Participates in orientation, instruction/training of new personnel. Manages and operates equipment safely and correctly. Knowledge/Skills/Abilities/Expectations Knowledge of medications and their correct administration based on age of the patient and their clinical condition. Basic computer knowledge. Able to organize tasks, develop action plans, set priorities and function under stressful situations. Ability to maintain a good working relationship both within the department and with other departments. Approximate percent of time required to travel: 0% Must read, write and speak fluent English. Must have good and regular attendance. Performs other related duties as assigned. Qualifications Education Graduation from an accredited Bachelor of Science in Nursing, Associate Degree in Nursing or Nursing Diploma program. Licenses/Certification Current state licensure as Registered Nurse. BCLS certification required. ACLS certifications preferred. Experience Minimum six months' Medical/Surgical experience in an acute care setting preferred. Job: RNPrimary Location: OH-Lima-Kindred Hospital-LimaOrganization: 4851 - Kindred Hospital-LimaShift: Night
    $59k-79k yearly est. Auto-Apply 4d ago
  • Clinical Appeals RN - Remote in EST or CST Time Zone

    Unitedhealth Group Inc. 4.6company rating

    Cypress, CA jobs

    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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. If you are located within Eastern Standard time zone, you will have the flexibility to work remotely* as you take on some tough challenges. The work schedule is generally Monday-Friday, 8-5 EST or 8-5 CST. Primary Responsibilities: * Perform initial assessment review of appeals, medical records, and CMS/State Policies to determine if care/services provided meets coverage and billable criteria to be paid * Identify if additional information is required to process an appeal * Ability to adapt to changes that require cross training on appeal types as they are identified * Ability to work independently * Utilize Clinical nursing judgment assessment and critical thinking skills, guided by regulatory policy, to make decision on administrative nurse level cases * Ability to navigate multiple computer programs, moving from one system to another, while managing multiple tasks and priorities 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: * Current, valid, and unrestricted RN licensure in your state of residence * 2+ years of clinical experience in an acute care or an outpatient setting * 1+ years of direct experience within one (or more) of the following areas: * Utilization Review * Medicaid and/or Medicare appeals experience * LOC assessment planning and Discharge SNF Planning including understanding of Denial Notice and NOMNC * Proven experience/understanding of billable services and claims in a managed care environment * Solid Microsoft Office (Word, Excel & Outlook) Basic computer skills * Access to high-speed internet * Ability to work 8-5 within EST (Eastern standard time zone) Preferred Qualifications: * 5+ years of Medical Appeal experience working with Medicare and Medicaid * Solid coding experience or Certified Coder (CPC) * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly 2d ago
  • Clinical Appeals RN (M&R) - Remote (M-F 8-5)

    Unitedhealth Group Inc. 4.6company rating

    Cypress, CA jobs

    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. As a Clinical Appeals RN for UHC Clinical Services, you will work on post-service appeals for Medicare-based claims. Primary Responsibilities: * Review provider post-service appeals for Medicare and Retirement * Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines * Discuss cases with medical directors when applicable * Ability to communicate and collaborate with other teams in order to gather medical information to process cases * Communicate effectively in both verbal and written documentation * Must meet quality and productivity metrics * Ability to work independently and prioritize * Attend mandatory trainings and scheduled staff meetings * Engage in respectful and courteous team dialog via email, IM and in staff meeting 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 * Unrestricted, active RN license * 2+ years of RN experience in acute setting * Proven working knowledge of Clinical Criteria and CMS Guidelines/InterQual * Proven proficiency in basic computer skills * Demonstrated ability to have high speed internet installed in home for Secure Job use only * Proven designated HIPPA compliant home workspace Preferred Qualifications: * Undergraduate degree (BSN) * Proven utilization management, prior authorization, case management or prior appeals experience * Proven claims and coding experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly 25d ago
  • Clinical Appeals RN (M&R) - Remote (M-F 8-5)

    Unitedhealth Group 4.6company rating

    Cypress, CA jobs

    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.** As a Clinical Appeals RN for UHC Clinical Services, you will work on post-service appeals for Medicare-based claims. **Primary Responsibilities:** + Review provider post-service appeals for Medicare and Retirement + Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines + Discuss cases with medical directors when applicable + Ability to communicate and collaborate with other teams in order to gather medical information to process cases + Communicate effectively in both verbal and written documentation + Must meet quality and productivity metrics + Ability to work independently and prioritize + Attend mandatory trainings and scheduled staff meetings + Engage in respectful and courteous team dialog via email, IM and in staff meeting 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 + Unrestricted, active RN license + 2+ years of RN experience in acute setting + Proven working knowledge of Clinical Criteria and CMS Guidelines/InterQual + Proven proficiency in basic computer skills + Demonstrated ability to have high speed internet installed in home for Secure Job use only + Proven designated HIPPA compliant home workspace **Preferred Qualifications:** + Undergraduate degree (BSN) + Proven utilization management, prior authorization, case management or prior appeals experience + Proven claims and coding experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $28.3-50.5 hourly 25d ago
  • Service Care Coordinator RN - Remote in South Austin, TX

    Unitedhealth Group Inc. 4.6company rating

    Austin, TX jobs

    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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together This is a Field Based role with a Home-Based office. Must be open to traveling up to 50 miles from home office based on business need. If you are located in or within commutable driving distance from South Austin, TX, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: * Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, at least restrictive level of care * Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services * Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members * Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: * Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays * Medical Plan options along with participation in a Health Spending Account or a Health Saving account * Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts * Employee Assistance Program * Employee Referral Bonus Program * Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) * More information can be downloaded at: ************************* 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: * Current and unrestricted Registered Nurse license in the state of Texas * 2+ years of experience working within the community health setting or in a healthcare role * Intermediate level of computer proficiency (including Microsoft Outlook, Teams) and ability to use multiple web applications * Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service * Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) * Valid driver's license, access to reliable transportation and the ability to travel in this 'assigned region' to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices * Reside in or within commutable driving distance from South Austin, TX Preferred Qualifications: * 1+ years of experience with long-term care services and support, Medicaid or Medicare * Knowledge of the principles of most integrated settings, including federal and State requirements like the federal home and community-based settings regulations * Proven ability to create, edit, save and send documents, spreadsheets and emails * Reside in South Austin, TX * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly 9d ago
  • Governmental Audit Reviewers RN - Remote

    Unitedhealth Group Inc. 4.6company rating

    Lafayette, LA jobs

    Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As a Governmental Audit Reviewer, you are the expert who ensures clinical documentation stands up to scrutiny. You take the lead in auditing, submitting, and appealing records for home health, hospice, LTACHs, and community-based services. When external payers come calling-whether it's ADRs, CERTs, RACs, ZPICs, or other audits-you're ready. You dive into the details, respond with precision, and defend the integrity of care through every pre- and post-payment review. Your work protects reimbursement, supports compliance, and keeps the organization audit-ready at all times. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Reviews clinical documentation for Home Health, Hospice, LTACHs, and Community-Based Services in response to governmental audits (e.g., ADRs, RACs, CERTs, ZPICs) * Ensures consistency in clinical reviews through standardized processes and high inter-rater reliability * Drafts professional response letters and manages internal determinations for audit appeals * Coordinates and tracks appeal assignments, ensuring deadlines are met and documentation is prepared for Administrative Law Judge hearings * Maintains up-to-date knowledge of federal/state regulations, industry standards, and internal policies related to compliance and reimbursement * Collaborates across departments to minimize operational disruptions and communicate audit trends for corrective action * Supports the Governmental Audit Supervisor with repayment processes and additional compliance audits 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: * Associate's degree in Nursing * Current and unrestricted licensure as a LPN * 1+ years of experience in hospice, LTACH, and/or home health care * Working knowledge of reimbursement and compliance regulations * Proficient in Microsoft Office applications (Word, Excel, etc.) Preferred Qualifications: * Bachelor's degree in Nursing * Experience in auditing and analyzing clinical documentation * Demonstrated leadership qualities * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $58.8k-105k yearly 2d ago
  • Governmental Audit Reviewers RN - Remote

    Unitedhealth Group 4.6company rating

    Lafayette, LA jobs

    Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As a Governmental Audit Reviewer, you are the expert who ensures clinical documentation stands up to scrutiny. You take the lead in auditing, submitting, and appealing records for home health, hospice, LTACHs, and community-based services. When external payers come calling-whether it's ADRs, CERTs, RACs, ZPICs, or other audits-you're ready. You dive into the details, respond with precision, and defend the integrity of care through every pre- and post-payment review. Your work protects reimbursement, supports compliance, and keeps the organization audit-ready at all times. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Reviews clinical documentation for Home Health, Hospice, LTACHs, and Community-Based Services in response to governmental audits (e.g., ADRs, RACs, CERTs, ZPICs) + Ensures consistency in clinical reviews through standardized processes and high inter-rater reliability + Drafts professional response letters and manages internal determinations for audit appeals + Coordinates and tracks appeal assignments, ensuring deadlines are met and documentation is prepared for Administrative Law Judge hearings + Maintains up-to-date knowledge of federal/state regulations, industry standards, and internal policies related to compliance and reimbursement + Collaborates across departments to minimize operational disruptions and communicate audit trends for corrective action + Supports the Governmental Audit Supervisor with repayment processes and additional compliance audits 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:** + Associate's degree in Nursing + Current and unrestricted licensure as a LPN + 1+ years of experience in hospice, LTACH, and/or home health care + Working knowledge of reimbursement and compliance regulations + Proficient in Microsoft Office applications (Word, Excel, etc.) **Preferred Qualifications:** + Bachelor's degree in Nursing + Experience in auditing and analyzing clinical documentation + Demonstrated leadership qualities *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _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._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $58.8k-105k yearly 2d ago
  • DRG CVA RN Auditor - National Remote

    Unitedhealth Group 4.6company rating

    Minnetonka, MN jobs

    **$10,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS** Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together** . In this position as a **Coding & Clinical Auditor / DRG Specialist RN** , you will apply your expert knowledge of the MS-DRG and APR-DRG coding/reimbursement methodology systems, ICD-10 Official Coding Guidelines, and AHA Coding Clinic Guidelines in the auditing of inpatient claims. Employing both industry and Optum proprietary tools, you will validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses billed by hospitals to identify overpayments. Utilizing excellent communications skills, you will compose rationales supporting your audit findings. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Conduct MS-DRG and APR-DRG coding reviews to verify the accuracy of DRG assignment and reimbursement with a focus on overpayment identification + Utilize expert knowledge to identify the ICD-10-CM/PCS code assignment, appropriate code sequencing, present on admission (POA) assignment, and discharge disposition, in accordance with CMS requirements, ICD-10 Official Guidelines for Coding and Reporting, and AHA Coding Clinic guidance + Apply current ICD-10 Official Coding Guidelines and AHA Coding Clinic citations and demonstrate working knowledge of clinical criteria documentation requirements used to successfully substantiate code assignments + Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding and billing + Utilize solid command of anatomy and physiology, diagnostic procedures, and surgical operations developed from specialized training and extensive experience with ICD-10-PCS code assignment + Write clear, accurate and concise rationales in support of findings using ICD-10 CM/PCS Official Coding Guidelines, and AHA Coding Clinics + Utilize proprietary workflow systems and encoder tool efficiently and accurately to make audit determinations, generate audit rationales and move claims through workflow process correctly + Demonstrate knowledge of and compliance with changes and updates to coding guidelines, reimbursement trends, and client processes and requirements + Maintain and manage daily case review assignments, with a high emphasis on quality + Provide clinical support and expertise to the other investigative and analytical areas + Work in a high-volume production environment that is matrix driven **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* 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:** + Associate's Degree (or higher) + Unrestricted RN (Registered Nurse) license + CCS/CIC or willing to obtain certification within 6 months of hire + 3+ years of MS DRG/APR DRG coding experience in a hospital environment with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies + 2+ years of ICD-10-CM coding experience including but not limited to: expert knowledge of principal diagnosis selection, complications/comorbidities (CCs) and major complications/comorbidities (MCCs), and conditions that impact severity of illness (SOI) and risk of mortality (ROM) + 2+ years of ICD-10-PCS coding experience including but not limited to: expert knowledge of the structural components of PCS such as selection of appropriate body systems, root operations, body parts, approaches, devices, and qualifiers **Preferred Qualifications:** + Experience with prior DRG concurrent and/or retrospective overpayment identification audits + Experience with readmission reviews of claims + Experience with DRG encoder tools (ex. 3M) + Experience using Microsoft Excel with the ability to create / edit spreadsheets, use sort / filter function, and perform data entry + Healthcare claims experience + Managed care experience + Knowledge of health insurance business, industry terminology, and regulatory guidelines **Soft Skills:** + Ability to use a Windows PC with the ability to utilize multiple applications at the same time + Demonstrate excellent written and verbal communication skills, solid analytical skills, and attention to detail + Ability to work independently in a remote environment and deliver exceptional results + Excellent time management and work prioritization skills **Physical Requirements and Work Environment:** + Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer + Have a secluded office area in which to perform job duties during the work day + Have reliable high - speed internet access and a work environment free from distractions *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $34.42 to $67.60 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _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: 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._ \#RPO #GREEN #RPOLinkedin
    $34.4-67.6 hourly 60d+ ago
  • Inpatient Care Management Nurse RN - Remote

    Unitedhealth Group Inc. 4.6company rating

    Eden Prairie, MN jobs

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Can you feel it? Bring that energy to a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As an Inpatient Care Management Nurse, you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. What makes your nursing career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. Schedule will be Monday through Friday from 8AM-5PM. Role does not require nights or Holidays however occasional weekend work may be required based off business needs. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (InterQual criteria) * Discuss cases with facility healthcare professionals to obtain plans-of-care * Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management * Participation in discussions with the Clinical Services team to improve the progression of care to the most appropriate level * Consult with the Medical Director, as needed, for complex cases and make appropriate referrals to downstream partners * Apply clinical expertise when discussing case with internal and external Case Managers and Physicians * Identify delays in care or services and manage with MD * Follow all Standard Operating Procedures in end to end management of cases * Obtain clinical information to assess and expedite alternate levels of care * Facilitate timely and appropriate care and effective discharge planning * Participate in team meetings, education, discussions, and related activities * Maintain compliance with Federal, State and accreditation organizations * Identify opportunities for improved communication or processes * Participate in audit activities and meetings 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: * Active, unrestricted RN license in state of residence * 3+ years of clinical nursing experience practicing clinically (Acute Inpatient, SNF/AIR/ LTAC, Emergency Department, Urgent Care) * Experience in acute, long-term care, acute rehabilitation, or skilled nursing facilities * Demonstrated proficiency in computer skills - Windows, IM, Excel (Microsoft Suite), Outlook, clinical platforms * Designated workspace and access to install secure high-speed internet via cable / DSL in home Preferred Qualifications: * Bachelor's degree * Compact RN license * 2+ years case management experience * 1+ years Background that involves utilization review and evidence-based guidelines (InterQual Guidelines) * Managed care experience * Experience performing discharge planning * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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: 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.
    $58.3k-114.3k yearly 60d+ ago
  • RN Clinical Director - Caretenders

    Unitedhealth Group Inc. 4.6company rating

    Columbus, OH jobs

    $5000 Sign On Bonus for External Candidates Explore opportunities with Caretenders, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Clinical Director, you will oversee and direct the patient care operations of the home care facility. This includes: coordinating and completing assigned projects to effectively support the immediate and long range objectives of the company; oversight of the eligibility of patients referred to home care services, planning for the services to be provided to patients and supervising their total home health care; implementing and maintaining administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations; enhancing the profitability of the agency; and providing motivation and retention of a qualified staff and assure the quality of services delivered. This position also acts as a liaison with management staff and other departments throughout the company. Primary Responsibilities: * Coordinates and completes assigned projects to effectively support the immediate and long-range objectives of the company * Oversees the eligibility of patients referred to home care services, planning for the services to be provided to patients and supervising their total home health care * Implements and maintains administrative practices, agency philosophy, goals, and policies which assure compliance with applicable state and federal regulations. * Enhances the profitability of the agency; and providing motivation and retention of a qualified staff and assure the quality of services delivered * All CMS and state regulations must be followed regarding supervision of nursing services * If Clinical Director is not an RN, Executive Director/Administrator or Patient Care Manager must be designated as supervising RN for nursing services unless state regulations dictate otherwise 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: * Current and unrestricted RN licensure in the state of practice or PT/OT/SLP, must have current applicable license in the state * Current CPR certification * Current Driver's License and vehicle insurance, and access to a dependable vehicle, or public transportation Preferred Qualifications: * 1+ years of supervisory and/or management experience in home health setting or related healthcare setting * Ability to manage multiple tasks simultaneously * Able to work independently * Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $46k-53k yearly est. 2d ago

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