Inpatient Authorization Nurse - Remote in LA Only

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 and start doing your life's best work.(sm)

The Authorization Nurse is responsible for engaging in the collaborative process which assesses, plans, implements, coordinates, monitors and evaluates services to help improve member’s health outcomes.

If you are located within the state of LA, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Review and documentation of requests for services via electronic transmittal and/or fax for inpatient services
• Processes the initial review for all hospitalized members within assigned facilities
• Collaborates with the interdisciplinary care team (ICT) and medical director(s) to facilitate appropriate treatment for members and identify high risk members that will be followed by the care coordinators
• Initiates care coordination (Nurse Practitioner, MSW, RN) referrals for members when necessary
• Monitors the member’s adherence to the plan of care
• Collaborates with the hospital case management staff and facility care providers to review admission and discharge planning
• When appropriate, involves and assists member and/or caregiver in continuation of care to the outpatient setting or alternative levels of care

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 Louisiana Registered Nurse (RN)
• Experience in a clinic/hospital or similar setting
• Experience with clinical documentation systems
• Experience in assessing members and developing care plans
• Computer/typing proficiency to enter/retrieve data in electronic clinical records and documentation systems, experience with email, internet research, use of online calendars and other software applications

Preferred Qualifications:

• Bachelor of Nursing
• 3+ years of clinical experience in health care and/or managed care
• Experience with medical terminology and coding
• Working knowledge in Interqual and CMS guidelines
• Understanding of healthcare industry
• Understanding of nursing home, skilled nursing facility and long-term acute care regulations

Careers at UnitedHealthcare M&R Underwriting & HCE. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.(sm)

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.