ROLE AND RESPONSIBILITIES
- The Clinical Appeals Nurse in Optum will ensure defensible and accurate case recommendations for concurrent admission, continued stay, and concurrent denial cases which are then reviewed by a Physician Advisor for completion of the concurrent and/or peer to peer review. They will be working directly with the Physician Advisors utilizing the guidance provided in order to make defensible and accurate case recommendations.
Your role is critical in allowing our members, families, facilities and health professionals to have greater confidence in the exceptional care we provide. And for you, an everyday opportunity to do your life's best work.
JOB QUALIFICATIONS
- Active PHRN License
- Strong Clinical Knowledge base with a minimum of 2 years of Critical Care bedside experience in a tertiary hospital (local/overseas), (areas: ICU, Critical Care Unit, Telemetry, Cardiovascular Intensive Care Unit, Medical Intensive Care Unit, ER)
- Hospital experience should be within 5 years.
- Willing to work onsite
WHAT WE OFFER
- Fixed Weekends Off
- Pure Non-Voice Account
- Market Competitive Pay Levels
- Retirement Plan
- Medical Plan (HMO) from Day 1 of employment
- Dental, Medical, and Optical Reimbursements
- Life and Disability Insurance
- Paid Time-Off Benefits
- Sick Leave Conversion
- Tuition Fee Reimbursement
- Employee Assistance Program (EAP)
- Annual Performance Based Merit Increases
- Employee Recognition
- Training and Staff Development
- Employee Referral Program
- Employee Volunteerism Opportunity
- All Mandatory Statutory Benefits
WHO WE ARE
- Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.
- UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
- We're a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.
- As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.
- Elevate your career with a leading health care company while improving lives.
Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that's dedicated to Caring. Connecting. Growing together
