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Onsite Inpatient Care RN - Onondago County, NY

UnitedHealth Group

Syracuse, NY
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Job Details

747083 Onsite Inpatient Care RN Onondago County NY

Onsite Inpatient Care RN - Onondago County, NY (747083)

Position Description

At UnitedHealth Group, you’ll improve the health of others while you help us heal the entire health care system. As a Utilization Management Nurse, you will make sure our health services are administered efficiently and effectively. You’ll assess and interpret member needs and identify solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready make an impact? Join us today.
Primary Responsibilities: 
  • Represent UHC working onsite at multiple Skilled Nursing Facility in the Onondago County, NY Area
  • Perform utilization and concurrent review of inpatient cases using Milliman criteria
  • Conduct clinical chart assessments
  • Build and maintain relationships
  • Discuss cases with treating physicians and other healthcare professionals to better understand plans-of-care
  • Participate in rounds with the Medical Director and discussing cases as needed
  • Determine need, if any, for intervention and discussing with Case Managers and physicians
  • Identify and evaluate delays in care
  • Initiate a discharge planning and readmission prevention plan
  • Approve bed days for inpatient cases (when applicable)
  • Arrange alternative care services; contact and maintain communication with acute long term care, acute rehabilitation, or skilled nursing facilities to move patients through the care continuum
  • Gather clinical information to assess and expedite care needs
  • Facilitate timely and appropriate care and effective discharge planning including follow up phone calls to the member after discharge
  • Participate in team meetings, education discussions, and related activities
  • Maintain appropriate documentation
  • Consult with the Medical Director as needed to troubleshoot difficult or complex cases
  • Identify opportunities for improved communication or processes
  • 80% Travel - Daily visit to various Skilled Nursing Facilities in Onondago County, NY and surrounding area
  • Participate in telephonic and in-person staff meetings
Required Qualifications:  
  • A current, unrestricted RN license in New York
  • 1 year or more of UM / UR experience required including experience performing admission and continued inpatient stay reviews using either Interqual or MCG criteria
  • Demonstrate a proficiency in computer skills - windows, IM, excel (Microsoft suite), Outlook, clinical platforms
  • Minimum of 3 years total RN experience including recent clinical experience in an Skilled Nursing or Managed Care setting
  • Must be willing to work onsite at multiple local Skilled Nursing Facilities in the Onondago County, NY and surrounding area. (Relocation expenses not available for this positon)
  • Must have a work space in their home that is separated from non-workspace areas and that can be secured to maintain Protected Health Information (PHI) and / or Protected Information (PI)
  • Must be living in a location that can receive high-speed internet service with a minimum speed of 1.5 download mps & 1 upload mps. Mobile cellular data, e.g., fixed wireless, air cards / MiFi devices, and satellite are not approved means of internet connectivity and do not meet the criteria for high-speed internet connection through an Internet Service Provider
Preferred Qualifications: 
  • Bachelor’s degree
  • 2 or more years of case management experience
  • Case management certification and / or experience
  • Experience in acute long term care, acute rehabilitation, or skilled nursing facilities
  • Experience in discharge planning and / or chart review
  • Experience with utilization review for an insurance company or in a managed care environment
  • Familiarity with Milliman criteria guidelines
  • Managerial experience
If you’re the kind of Nurse who wants to bring your compassion and your contributions to a new level every day, join us. You’ll discover an opportunity to do your life’s best work.(sm)
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.
Job Keywords: Registered Nurse, RN, RN Case Manager, Utilization Manager, Utilization Review RN, Concurrent Review RN, UM Nurse, CCR RN, Managed Care, case management, MCG, SNF

Job Details

  • Contest Number747083
  • Job TitleOnsite Inpatient Care RN - Onondago County, NY
  • Job FamilyNursing
  • Business SegmentUHC Clinical Services

Job Location Information

  • Syracuse, NY
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelYes, 75 % of the Time
  • Telecommuter PositionNo
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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