At UnitedHealthcare, we are dedicated to transforming the health care experience, fostering healthier communities, and breaking down barriers to access quality care. The work you do with us will enhance the lives of millions, contributing significantly to a more responsive, affordable, and equitable health care system. Are you ready to make a real impact? Join us in our mission of Caring. Connecting. Growing together.

In this role, the Senior Clinical Admin Nurse will play a pivotal part in providing personalized support to UMR members and their families. As a clinical liaison nurse, your primary focus will be to empower individuals to lead fulfilling lives while coordinating and collaborating with both internal and external partners, including consumers, caregivers, and clinical teams.

Candidates should be available to work Monday through Friday, from 8:00 am to 5:00 pm. Enjoy the flexibility of remote work from anywhere in the U.S. as you address some challenging health care issues.

Key Responsibilities:

• Equip members with the necessary tools and educational resources to navigate the health care system efficiently and manage their health concerns.
• Provide education and support concerning behavioral health services and substance use disorders (BHSUD).
• Assist members with understanding adverse determinations, including the appeals process.
• Teach members to utilize UMR’s online wellness tools and resources effectively.
• Conduct outreach to members for pre-admission counseling and post-discharge planning.
• Maintain meticulous records of all activities and documentation for comprehensive reporting.
• Accept and process referrals, evaluate available services, and coordinate medical care and community referrals when necessary.
• Adhere to all policies, procedures, and documentation standards required in relevant systems and databases.
• Actively participate in treatment plan discussions.
• Perform additional duties as assigned.

Our rewarding environment acknowledges and celebrates your performance, guiding you on a clear path to success while providing avenues for professional growth in various roles.

Required Qualifications:

• An active and unrestricted RN compact license.
• A nursing license in New York State or the ability to obtain one within three months of hire.
• A minimum of 2 years of acute nursing experience.
• At least 2 years of experience in behavioral health nursing.
• 2 years of case management experience.
• Basic proficiency in computer applications (e.g., MS Word, Outlook).
• Demonstrated ability to work independently and responsibly with minimal supervision.

Preferred Qualifications:

• Bachelor’s degree in nursing.
• Certified Case Manager (CCM) credential.
• 2+ years of experience in managed care settings.
• Experience in critical care, pediatrics, med-surg, and/or telemetry.
• Familiarity with utilization management processes.
• Experience with adverse determinations.
• Previous telecommuting experience.

Soft Skills:

• Exceptional verbal and written communication abilities.
• A strong customer service orientation.
• Proven teamwork and collaboration skills.
• Adaptability to take on responsibilities in a constantly evolving work environment.

Please note that all remote employees must comply with UnitedHealth Group’s Telecommuter Policy.

Compensation is based on various factors, including local labor markets, education, work experience, and certifications. In addition to a competitive salary, which ranges from $58,800 to $105,000 annually based on full-time employment, we offer a comprehensive benefits package that includes incentive programs, equity stock purchase options, and 401k contributions (subject to eligibility requirements). Wherever you begin your career with us, you’ll find a wide array of benefits and incentives.

Application Deadline: This position will remain open for a minimum of two business days or until a sufficient candidate pool is achieved. The posting may close earlier depending on applicant volume.

At UnitedHealth Group, we are committed to promoting health equity and ensuring that everyone, regardless of race, gender, sexuality, age, location, or income, has the opportunity to live their healthiest life. We recognize the numerous barriers to good health that disproportionately impact communities of color and historically marginalized groups. That’s why we are dedicated to delivering equitable care that addresses health disparities and improves health outcomes.

UnitedHealth Group is an Equal Employment Opportunity employer. Qualified applicants will receive consideration for employment regardless of race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or any other protected characteristic under applicable laws.

UnitedHealth Group maintains a drug-free workplace. Candidates must pass a drug test before starting employment.