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Utilization Management Registered Nurse - Washington D.C. - Care at Home
UnitedHealth Group
full-timePosted 6 days ago
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About this role
$5,000 Sign-on Bonus for External Candidates This position is open to candidates who live in DC, MD, or VA This is position is based in the greater Washington D.C. area. Standard Hours: Monday - Friday normal daytime business hours (no on-call, no weekends and no holidays required). Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum Care at Home team, together with an interdisciplinary care team we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. This life-changing work adds a layer of support to improve access to care. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. HCBS Utilization Management Nurse Position requires a District of Columbia RN License. This role works under the direct supervision of the DC Manager of Utilization Management, and is responsible for performing pre-service clinical coverage review of Private Duty Nursing (PDN) and Personal Care services (PCS) and other HCBS benefits using applicable benefit plan documents, evidence-based medical policy and nationally recognized clinical guidelines and criteria. Determines medical appropriateness of these services following evaluation of medical guidelines and benefit determination. This role requires a high degree of coordination with external and internal business partners, including, but not limited to the UnitedHealthcare clinical services inpatient, intake/prior authorizations, appeals and grievance, quality, case and disease management, behavioral health, and other clinical specialties, external HCBS
Read the full description and requirements on the original posting.
Tailor your resume for this Utilization Management Registered Nurse - Washington D.C. - Care at Home role
UnitedHealth Group and most employers screen applications with ATS software before a recruiter reads them, and they rank resumes that echo the language of the posting. To stand out for this role, mirror the exact skills, tools, and job title it uses. For healthcare & nursing roles like this one, recruiters commonly scan for:
- Patient Care
- BLS/ACLS
- EMR (Epic/Cerner)
- Charting
- Medication Administration
- HIPAA
- Vitals
- Care Planning
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Build a matching resume — freeFrequently asked questions
Is the Utilization Management Registered Nurse - Washington D.C. - Care at Home role at UnitedHealth Group remote?
The listing doesn't specify a location — check the original posting for details.
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