Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. Bring your skills and talents to a role where you'll have the opportunity to make an impact on a huge scale. This is the place to do your life's best work.(sm) As a Clinical Admin Nurse Consultant you will be responsible for the oversight of vendor relationships and compliance. Primary Responsibilities: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) Clinical Program Management (development, implementation and / or on-going management and administration of a clinical program(s) Provides strategic oversight and support, measurement standards and revisions as needed for delivery of programs focused on quality, affordability and outcomes)
Required Qualifications:Current, unrestricted RN license for the state of New York 3 years clinical experience UAS certification Computer / typing proficiency to enter / retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and MS ExcelPreferred Qualifications:Bachelor's degree Knowledge of NYS Medicaid regulations Quality and/or compliance experience MLTC experience Knowledge of ICUE softwareCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) 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. Job Keywords: RN, Registered Nurse, Nurse, Licensed, Care Coordinator, Case Manager, Case Management, UAS, UASNY, Quality, Compliance, Assessment RN, Medicare, Medicaid, Medicaid Waiver, Managed Care, Behavioral Health, Mental Health, Community Health, Long Term Care, MLTC, Hospice, Public Health, Assisted Living, CCM, Telecommuter, Telecommute, Telecommuting, Remote, UHG, UnitedHealth Group, UHC, UnitedHealthcare, Community and State, Public Sector, New York, NY, Bronx, Monroe, Manhattan, Syracuse
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.