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Utilization Management Registered Nurse - Washington D.C. - Care at Home

Optum

Remotefull-time60k–107kPosted 3 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

Optum 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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Frequently asked questions

Is the Utilization Management Registered Nurse - Washington D.C. - Care at Home role at Optum remote?

Yes — the employer has flagged this role as remote. Confirm any location or time-zone requirements on the original posting before applying.

What does the Utilization Management Registered Nurse - Washington D.C. - Care at Home role at Optum pay?

The listed pay is 60k–107k. Salaries vary with experience and location — treat this as a guide and confirm on the original posting.

How do I apply for this Utilization Management Registered Nurse - Washington D.C. - Care at Home job?

Applications happen on the employer's own site — use the "Apply on company site" link on this page. Before you apply, tailor your resume to the listing so it clears the ATS.

How do I tailor my resume for this Utilization Management Registered Nurse - Washington D.C. - Care at Home role?

Open Tailr's builder and it creates an ATS-friendly resume matched to this listing — pulling in the role's keywords and the skills healthcare & nursing recruiters scan for — with a live match score as you edit. It's free to start and needs no sign-up.

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Listing sourced via Indeed. Tailr indexes public job postings so you can tailor your resume to them — applications happen on the employer's site.