We’re Monarch HealthCare, Orange County’s largest association of independent physicians, and a part of Optum and the growing family of UnitedHealth Group companies. We are changing health care for the better by improving access to affordable, high quality care, and working together to improve the patient experience. With the talent, resources and can-do culture of a Fortune 14 company behind us, there’s no telling how far we can go. Join us in creating a better future and you’ll soon find you’re doing your life’s best work.(sm)
As a part of our continued growth, we are searching for a Utilization Management RN to join our team.
If you are located in Irvine, CA, you will have the flexibility to telecommute* as you take on some tough challenges.
- Review Prior Authorization requests via computer in an assigned queue
- Assess the requested service(s) against the clinical information; identify appropriate criteria to be used to evaluate the request
- Prepare and document all findings; approve authorizations that are within the nurse's scope to approve; prep all authorizations that need physician review for possible denial
- Meet all regulatory turn-around times and documentation requirements
- Participate in team huddles and discussions; be open to ideas and changes in processes
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.
- Unrestricted CA RN or LVN / LPN license
- 3+ years of clinical experience in a hospital, clinic, SNF, Home Health / Hospice setting
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
- Prior Authorization experience
- Solid Computer skills; able to use Outlook, Skype (instant messaging), and learn proprietary software systems
- Able to work in a virtual environment, using web ex, phone calls and support systems
- Able to multitask and perform in a high pressure setting with quick deadlines
- Team player
- Life-long learner
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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. Candidates are required to pass a drug test before beginning employment.