UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)
We currently seek experienced RNs with strong interpersonal skills to join our team. The Clinical Appeals RN will be responsible for reviewing appeals and provider inquiries for clinical eligibility for coverage as prescribed by the plan benefits.
This is a work from home/telecommute position Candidates must be able to work Monday - Friday from 8:00 am - 5:00 pm CST
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Works within Department of Labor and State guidelines
Adherence to all confidentiality regulations and agreements
Reviews and interprets Plan language appropriately
Utilizes clinical guidelines and criteria appropriately
Responsible for accurately documenting determinations
Effectively and professionally communicates with both internal and external customers/providers, following prescribed policies
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.
Active, unrestricted RN licensure in the state of residence
5+ years RN experience in an acute care inpatient setting
Proficient computer and typing skills (MS Word and Outlook)
Health Insurance industry experience
Home care experience
Knowledge of ICD - 10 / CPT coding
Knowledge or experience with InterQual
Knowledge of DOL and state appeals guidelines
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $26.15 to $46.63. The hourly range for Connecticut/Nevada residents is $28.85 to $51.30. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.
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 bylower 48 law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.