RN / LPN - Compliance & Utilization Review (Join a leader!)

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.



Evercare, a UnitedHealth Group company, is the nation's largest provider of essential, innovative products and programs specifically designed to serve aging and chronically ill Medicare and Medicaid patients. We offer our members a simple way of achieving better health.  Come to Evercare and discover the rare combination of a rewarding career and the opportunity to make a difference in people's lives.

 

We seek a dedicated nursing professional with utilization management experience to join our friendly team in Golden Valley. If you're ready for a refreshing change from direct patient care, consider this office-based position with a healthcare organization you can have confidence in. This position offers plenty of advancement potential and flexibility in a growing department.

 

Primary responsibilities include:
Overseeing utilization management and compliance activities for our Minnesota site
Following health-plan criteria and ensuring compliance within deadlines
Researching and adressing trends based on your review
Coordinating audits and creating corrective active plans to resolve identified issues
Updating the policy/procedure manual
Working closely with the Medical Director 



The chosen candidate must be an RN or LPN with a current, unrestricted license in the state of MN. Prior clinical case management or care management is needed; utilization management and compliance experience are essential. A background in an analytical role is key, and a knowledge of medical coding is a must. Computer proficiency is necessary. An MBA, MPH or Paralegal is a plus.

 

UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.

 

If you are interested in growing professionally within an innovative, highly respected organization, we invite you to explore this excellent growth opportunity!

 

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.