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Inpatient Care Management Nurse RN - Remote
Optum is hiring a remote Inpatient Care Management Nurse RN to review inpatient cases, ensure proper health service utilization, and collaborate on care progression. The role requires clinical nursing experience and an active RN license.
Job Description
Role Overview
As an Inpatient Care Management Nurse, you will ensure proper utilization of health services by assessing and interpreting member needs. Schedule varies to include some weekend requirements based on business needs.
Primary Responsibilities
- Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (InterQual criteria)
- Discuss cases with facility healthcare professionals to obtain plans-of-care
- Collaborate with Optum Enterprise Clinical Services Medical Directors on utilization management
- Consult with the Medical Director for complex cases and make appropriate referrals
- Identify delays in care or services and manage with MD
- Facilitate timely and appropriate care and effective discharge planning
- Maintain compliance with Federal, State, and accreditation organizations
Required Qualifications
- Active, unrestricted RN license in state of residence
- 3+ years of clinical nursing experience in a hospital setting
- Proficiency in computer skills (Windows, IM, Excel, Outlook, clinical platforms)
- Designated workspace and access to install secure high-speed internet in home
- Ability to work one weekend approximately every six weeks
Requirements & Skills
Specialty
Case Management
Experience
3+ years
Licenses
RN
Skills
Utilization ReviewInpatient Care ManagementDischarge PlanningInterQualCase ManagementClinical Nursing