UnitedHealth Group

Title: Oncology Utilization Manager RN – Telecommute anywhere in USA

Location: Houston Texas United States

Division:OH Ops-MBM Ops CMC
Contest Number: 817091
Family: Nursing
Function: Case Management
BusinessSegment: Optum Consumer Solutions Group
Region: North America
Country: United States
City: Houston
State: Texas
Other States:
Other Cities:
Employee Status:Regular
Job Level:Individual Contributor
Shift:Day Job
Overtime Status:Exempt
Telecommuter Position: Yes

Position Description

The Optum Oncology Utilization Manager will help ensure patients receive high-quality, evidence-based and cost-efficient oncology care. As such, this role requires an engaging, action-oriented clinician. This role will serve as a key component in the implementation of Optum’s next-generation oncology programs.

This position is telecommute / work from home from anywhere in US. The schedule is M – F, and you will work an 8 hours shift between the hours of 7am – 7pm Central Time. For example, shift could be approximately 7am – 4pm OR 10am – 7pm. There is potential for weekend and holiday on call coverage as needed.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Perform utilization review determinations for oncology populations (includes evaluating appropriateness and efficiency of requested health care services, procedures, and cancer treatments under the provisions of the applicable health benefits plan)
  • Engage with providers via outbound calls to assess patient’s current health status and coordinate care
  • Identify gaps or barriers in patient treatment plans (based on evidence-based guidelines)
  • Collaborate with Medical Directors on challenging cases
  • Document and track findings

This position will require active and unrestricted Nursing licensure in multiple US States. Selected candidate must be willing and able to obtain and maintain multiple state licensure. (Application fees and filing costs paid for by UHG)

Required Qualifications:

  • Active, unrestricted RN license in your state of residence
  • Multiple state licensure (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses required
  • 3+ years of recent Oncology experience in a Hospital setting, Acute Care, Direct Care experience or experience as an Oncology Telephonic Case Manager for an insurance company
  • Recent chemotherapy administration experience OR Oncology Utilization Management experience
  • Access to high speed internet and dedicated work space from home

Preferred Qualifications:

  • BSN
  • Utilization Management experience
  • Experience working with NCCN (National Comprehensive Cancer Network) guidelines
  • OCN or other oncology related certifications
  • Experience in medical care delivery systems, case management, disease management, quality management, and/or product development
  • A background in managed care
  • Certified Case Manager (CCM)
  • Bilingual (Spanish/English) skills

Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make the health system 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.

Job Keywords: Oncology, Cancer, Case Manager, Care Coordinator, Utilization Management, Utilization Review, RN, Nurse, Chemotherapy, Infusion, National Comprehensive Cancer Network, NCCN, OCN, CCM, telecommute, work from home, virtual

Job Details

  • Requisition Number817091
  • Job TitleOncology Utilization Manager RN – Telecommute anywhere in USA
  • Job FamilyNursing
  • Business SegmentOptum Consumer Solutions Group

Job Location Information

  • Houston, TX
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter Position Yes
  • Overtime StatusExempt