Onsite Utilization Management Nurse RN - New York, NY
UnitedHealth Group - New York, NY

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There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm)

The Utilization Management Nurse is responsible for utilization management, utilization review, or concurrent review (Onsite inpatient care management). The UM Nurse will performs reviews of current inpatient services, and determine medical appropriateness of inpatient services following evaluation of medical guidelines and benefit determination. Generally work is self-directed and not prescribed.

Get better informed to determine your fit into this position. Click here to view the Realistic Job Preview: Onsite_UM_Nurse.pdf

Primary responsibilities:
  • Assesses and interprets customer needs and requirements
  • Identifies solutions to non-standard requests and problems
  • Solves moderately complex problems and/or conducts moderately complex analyses
  • Works with minimal guidance; seeks guidance on only the most complex tasks
  • Translates concepts into practice
  • Provides explanations and information to others on difficult issues
  • Coaches, provides feedback, and guides others
  • Acts as a resource for others with less experience
UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.
Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.
  • Unrestricted RN license in New York required
  • 5+ yrs Managed Care and/or Hospital Clinical experience as an RN required
  • Strong computer proficiency, must be able to type in addition to navigating around a Windows environment and using multiple applications simultaneously
  • Strong communication skills, written and verbal
  • Strong organizational skills

Additional Assets Preferred:
  • Case Management experience preferred
  • Certified Case Manager (CCM)
  • Undergraduate degree or equivalent experience.
  • Med/Surg experience a plus
  • Experience with Milliman
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we...