- Develop monthly case studies, identifying payer and hospital operational opportunities
- Compile reports as requesting by the ROS client and operations, specific to payers, operations and clinical reviews
- Participate in performance meetings as requested by ROS client and operations
- Develop and conduct quality reviews of all clinical reviews, including training
- Advanced level of proficiency utilizing Microsoft Office applications to include: Excel, Word, and PowerPoint
- Intermediate level of proficiency in evidence-based protocols- Hospital Case Management such as Milliman and/or Interqual guidelines
- Intermediate level of proficiency analyzing data and presenting those findings to both leadership and operational teams
- Ability to travel up to 25% of the time
- All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
-
Advance Nurse Practitioner
4 weeks ago
PEACEFIELD DOWNTON ST PETE LLC Tampa, United States Full timeSEROTONIN Anti-Aging Centers is seeking an experienced Nurse Practitioner specializing in Women's Health, Men's Health, Anti-Aging Medicine and Bio-Identical Hormone Replacement Therapy. The Nurse Practitioner will be dedicated to helping clients/members/guests lead healthy lives ...
-
Advance Nurse Practitioner
2 weeks ago
Serotonin Anti-Aging Centers Tampa, United StatesJob Description · Job DescriptionSEROTONIN Anti-Aging Centers is seeking an experienced Nurse Practitioner specializing in Women's · Health, Mens Health, Anti-Aging Medicine and Bio-Identical Hormone Replacement Therapy. The · Nurse Practitioner will be dedicated to helping clien ...
-
Advanced Practice Nurse
2 weeks ago
Department of Defense Tampa, United StatesAdvanced Practice Nurse (Nurse Practitioner) · Summary · This is a Direct Hire Authority (DHA) solicitation utilizing the DHA for Certain Personnel of the DoD Workforce to recruit and appoint qualified candidates to positions in the competitive service. · About the Position: The ...
-
Icu Rn, Registered Nurse Advanced Skills
1 week ago
Kindred Hospital Central Tampa Tampa, United States**Description** · Kindred Hospital Central Tampa is a 102-bed long-term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery period; featuring five negative pressure rooms. We partner with your physician and ...
-
Advanced Registered Nurse Practitioner
2 weeks ago
Get In Line Inc Tampa, United StatesJob Description · Job DescriptionPerforming physical exams and patient observations. · Recording patients' medical histories and symptoms. · Creating patient care plans and contributing to existing ones. · Ordering, administering, and analyzing diagnostic tests. · Diagnosing heal ...
-
ICU RN, Registered Nurse Advanced Skills
3 weeks ago
Kindred Hospitals Tampa, United StatesDetails Posted: 10-May-24 · Location: Tampa, Florida · Salary: Open · Categories: · General Nursing Internal Number: 508270 · Description · Kindred Hospital Bay Area – Tampa is a 73-bed long term acute care hospital offering the same in-depth care you would receive in a tra ...
-
Advanced Practice Nurse
1 day ago
Department of Defense Tampa, FL, United StatesAdvanced Practice Nurse (Nurse Practitioner) · Summary · This is a Direct Hire Authority (DHA) solicitation utilizing the DHA for Certain Personnel of the DoD Workforce to recruit and appoint qualified candidates to positions in the competitive service. · About the Position: The ...
-
Advanced Practice Nurses
1 day ago
Department of Defense Tampa, FL, United StatesThis is a Direct Hire Authority (DHA) solicitation utilizing the DHA for Certain Personnel of the DoD Workforce to recruit and appoint qualified candidates to positions in the competitive service. · About the Position: The incumbent will serve as an Advanced Practice Nurse (Nurse ...
-
Advanced Practice Nurses
1 day ago
Privia Health Tampa, FL, United StatesPrimary Care Nurse Practitioner - Tampa, FL · We are currently looking for a primary care nurse practitioner or physician assistant to join our primary care practice in Tampa, FL. · * Outstanding opportunity to join an expanding practice and work alongside a board certified fami ...
-
ICU RN, Registered Nurse Advanced Skills
1 day ago
Kindred Hospital - Central Tampa Tampa, FL, United StatesICU RN, Registered Nurse Advanced Skills - NIGHT · Kindred Hospital Central Tampa is a 102-bed long-term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery period; featuring five negative pressure rooms. ...
-
ICU RN, Registered Nurse Advanced Skills
1 day ago
Kindred Hospital - Central Tampa Tampa, FL, United StatesICU RN, Registered Nurse Advanced Skills · Kindred Hospital Bay Area - Tampa is a 73-bed long term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with you physician and offer 24-hou ...
-
icu rn, registered nurse advanced skills
3 weeks ago
Kindred Healthcare Tampa, FL , USA, United StatesKindred Hospital Bay Area - Tampa is a 73-bed long term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with you physician and offer 24-hour clinical care seven days a week so you can ...
-
Home Health Advanced Practice Registered Nurse
2 weeks ago
Tampa Family Health Centers Tampa, United StatesJob Description · Job DescriptionAre you ready to embark on a career journey that's more than just a job? At Tampa Family Health Centers (TFHC), we're redefining healthcare, and looking for a Home Health Advanced Practice Registered Nurse to be part of our dynamic team. We're not ...
-
Advanced Practice Registered Nurse
3 weeks ago
SOUTH SHORE CARDIOVASCULAR ASSOCIATES, INC. Tampa, United StatesJob Description · Job DescriptionLooking for 2 advanced practice registered nurses for a busy cardiology practice. Inpatient experience in cardiology desired but not a must. This is mainly an inpatient position but there will be outpatient work as well, depending upon need of pra ...
-
Advanced Nurse
4 days ago
Manatee Memorial Hospital Wimauma, FL, United StatesAbout Manatee Memorial Hospital (MMH): · Manatee Memorial Hospital in Bradenton, Florida, has served the citizens of Manatee, Sarasota and surrounding counties for over 70 years. Part of the Manatee Healthcare System, the hospital has earned The Joint Commission's Gold Seal of A ...
-
ICU RN, Registered Nurse Advanced Skills
3 weeks ago
Kindred Hospitals Tampa, United States· Kindred Hospital Bay Area – Tampa is a 73-bed long term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with you physician and offer 24-hour clinical care seven days a week so you ...
-
ICU RN, Registered Nurse Advanced Skills
1 day ago
Kindred Hospital - Central Tampa Tampa, FL, United StatesICU RN, Registered Nurse Advanced Skills · Kindred Hospital Central Tampa is a 102-bed long-term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery period; featuring five negative pressure rooms. We partn ...
-
ICU RN, Registered Nurse Advanced Skills
1 week ago
Kindred Hospitals Tampa, United StatesDetails Posted: 30-May-24 · Location: Tampa, Florida · Salary: Open · Categories: · General Nursing Internal Number: 510151 · Description · Kindred Hospital Bay Area – Tampa is a 73-bed long term acute care hospital offering the same in-depth care you would receive in a tra ...
-
ICU RN, Registered Nurse Advanced Skills
4 weeks ago
Kindred Hospitals Tampa, United StatesDetails Posted: 03-May-24 · Location: Tampa, Florida · Salary: Open · Categories: · General Nursing Internal Number: 507371 · Description · Kindred Hospital Bay Area – Tampa is a 73-bed long term acute care hospital offering the same in-depth care you would receive in a tra ...
-
One Medical Centers Clearwater, United States**About Us**:One Medical Center is a brand new multi-disciplinary medical facility in Clearwater, FL, dedicated to providing top-quality healthcare services to our community and international tourists. Our state-of-the-art center is equipped with the latest medical technology and ...
Advanced Nurse - Tampa, FL, United States - UnitedHealth Group Inc
Description
Sr Utilization Management Nurse RN - Remote NationwideOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.
The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.
Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities.Come make an impact on the communities we serve as you help us advance health equity on a global scale.
The Clinical Quality RN is responsible for conducting clinical reviews to justify and dispute payer denials. The role will develop case studies, coordinate with hospital operations and payers to ensure optimal results in denial prevention. The clinical denial coordinator will oversee quality assurance for clinical denials, including development of protocol and training.Schedule:
Monday - Friday - 8 AM - 4:30 PM in candidates time zone
You'll enjoy the flexibility to telecommute* from anywhere within the U.Provide clinical argument, using available Medical Records, to justify and dispute payer denials, all levels of appeals included
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
5+ years of Utilization Review or Case Management nursing experienceWashington Residents Only:
The salary range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island or Washington residents is $70,200 to $137,800 per year.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable.In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
Application Deadline:
This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.
Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes.
We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere:
UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and 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.