OptumCare Utilization Management

UnitedHealth Group
Type

Junior industry position

Position Description

Optum Medical Network is a network of health care providers in the Utah, whose mission is to connect and support providers by working together to deliver the most effective and compassionate care to each and every patient they serve. Optum Medical Network’s focus is to do the right things for patients, physicians, and the community. Optum Medical Network’s Core Business is contracting directly with health insurers to deliver a highly personal care management and service model to their patients. The current focus of Optum Medical Network is on seniors, and those with complex care needs, who most benefit from a high touch model of care. For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm) Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm) Primary Responsibilities:

  • Perform reviews of current inpatient services
  • Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
  • Ensure that health services that are being provided are appropriate
  • Concurrent review of patient’s clinical information for efficiency
  • Coordinate patient’s discharge planning needs with healthcare team
  • Employ effective use of knowledge, critical thinking skills
  • Work in a fast-paced environment with frequent collaboration amongst the team
  • Coach, provide feedback, and guide others
  • Act as a resource for others with less experience
  • Identify solutions to non-standard requests and problems
  • Solve moderately complex problems and / or conduct moderately complex analyses
  • Work with minimal guidance; seek guidance on only the most complex tasks
  • Translate concepts into practice

Required Qualifications:

  • Current, unrestricted RN license in the State of Utah, undergraduate degree or equivalent experience
  • 2+ years of clinical experience in a hospital, acute care, and direct care or case management
  • Computer / typing proficiency to enter / retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications
  • Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
  • Ability to communicate complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

© 2018 OptumCare. All Rights Reserved.

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Utilization management RN, registered nurse, inpatient services, West Valley, UT, Utah, RN, Utilization Management, acute care, clinical, case management

  • Job FamilyNursing
  • SANDY-Utah, UT

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Diversity creates a healthier atmosphere: 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.

More Information

Type

Junior industry position

United States