Description:
We have a specialized Nursing opportunity as a Clinical Administrative Consultant RN available at our United Healthcare office in Omaha Nebraska.
The Clinical Administrative Consultant RN is responsible for providing clinical expertise in any of the following areas:
- Clinical Interface/Liaison (clinical problem solver with facilities, providers, carriers; resolution of issues concerning members, benefit interpretation, program definition and clarification);
- Clinical Operations Analysis (monitors and analyzes medical management activities; provides analytical support to clinical programs; may perform clinical assessments and clinical audits);
- Clinical Training (planning, coordinating, delivering and evaluating clinical training);
- Clinical Writing (writing nursing tools and reference information to support the design of clinical products and services).
- Reviews the work of others.
- Develops innovative approaches.
- Sought out as expert.
- Serves as a leader/ mentor.
* Previous RN clinical work experience in Long term care, NICU, or Oncology is highly preferred*
Work schedule: 8:30 am- 5:00pm; Mon Fri/ NO weekends or holidays
Location:UHG Omaha, NEoffice
Qualifications:
Required Qualifications of this position include:
- Current, and unrestricted RN license for the state of Nebraska
-5+ years of RNwork experience in a practice, clinic, hospital, acute care, direct care setting, or at aninsurance company
- Knowledge of Managed Care organization
- Knowledge of Long Term Care
- Understanding of Medicaid policy and procedures
- Demonstrate understanding of Health Plan Operations and Networks for purposes of complaint investigation
- Must be conversant in Health Care Affordability Initiatives and skilled at engaging correct resources to achieve HCAI targets
- Must be able to work efficiently and effectively with Business Intelligence and other IT resources to problem solve and create required reporting for State requirements and for operations analysis
- Must demonstrate excellent people skills for inquiries and State Fair Hearings (involves members and the State)
- Ability to accurately and objectively assess situations and determine facts and best strategy for action
- Proficient level of experience with Microsoft Word and Excel, with the ability to navigate a Windows environment
- Strong organizational skills and multitasking abilities
- Excellent skills for problem analysis and problem solving
UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If youre ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community & State.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
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.
key words: RN, Nurse, registered nurse, long term care, oncology, NICU, managed care acute care, Omaha, NE,charge nurse, independentliving
Country: USA, State: Nebraska, City: Omaha, Company: UnitedHealth Group.
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