Preservice Review LPN - Remote
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
Optums Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California, to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.
This position is full-time (40 hours/week). Employees are required to have flexibility to work any shift schedules during normal business hours in the Mountain or Pacific time zones, to include weekend coverage.
Primary Responsibilities:
Understand and follow standardized processes for managing add or change requests and implementing requests in the letter generation system
Create and review denial letters to determine compliance with contractual and regulatory requirements of the State and Federal programs, while reviewing for efficiencies and effectiveness of procedures
Performs internal Quality Control reviews on processes and activities regarding letter writing
Identify and correct letter deficiencies
Work independently or in a team environment
Demonstrate high attention to detail, exceptional documentation abilities, and organizational skills
Collaborate with our business partners, Letter Owners, and other Letter Maintenance Administrators (LMAs) regarding letter template design and development
Develop new templates and / or change templates for approved letter requests
Promote tested letter templates to production
Analyze inventory and identify opportunities to streamline, decommission, combine, etc.
Summarize results / recommendations and present findings to supervisor
Other duties as assigned by supervisor which fall into the scope of practice
Youll 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.
Required Qualifications:
LPN nurse (current and unrestricted) - compact state license, able to obtain endorsement licensures for other states as needed
1 years of direct clinical patient care
Knowledge of managed care principles
Knowledge of medical terminology
Proven solid interpersonal, oral, and written communication skills
Proven basic computer skills
Proven excellent written skills - grammar and punctuation
Proven detail oriented
Proven comfortable working with medical directors
Preferred Qualifications:
3 years of direct clinical patient care
1 years of experience with medical management activities in a managed care environment
The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, youll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Apply Now
Optums Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California, to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.
This position is full-time (40 hours/week). Employees are required to have flexibility to work any shift schedules during normal business hours in the Mountain or Pacific time zones, to include weekend coverage.
Primary Responsibilities:
Understand and follow standardized processes for managing add or change requests and implementing requests in the letter generation system
Create and review denial letters to determine compliance with contractual and regulatory requirements of the State and Federal programs, while reviewing for efficiencies and effectiveness of procedures
Performs internal Quality Control reviews on processes and activities regarding letter writing
Identify and correct letter deficiencies
Work independently or in a team environment
Demonstrate high attention to detail, exceptional documentation abilities, and organizational skills
Collaborate with our business partners, Letter Owners, and other Letter Maintenance Administrators (LMAs) regarding letter template design and development
Develop new templates and / or change templates for approved letter requests
Promote tested letter templates to production
Analyze inventory and identify opportunities to streamline, decommission, combine, etc.
Summarize results / recommendations and present findings to supervisor
Other duties as assigned by supervisor which fall into the scope of practice
Youll 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.
Required Qualifications:
LPN nurse (current and unrestricted) - compact state license, able to obtain endorsement licensures for other states as needed
1 years of direct clinical patient care
Knowledge of managed care principles
Knowledge of medical terminology
Proven solid interpersonal, oral, and written communication skills
Proven basic computer skills
Proven excellent written skills - grammar and punctuation
Proven detail oriented
Proven comfortable working with medical directors
Preferred Qualifications:
3 years of direct clinical patient care
1 years of experience with medical management activities in a managed care environment
The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, youll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Apply Now