Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)
If you are located in Pittsburgh, PA, Cleveland, OH, Washington, D.C., Batlimore, Maryland, Philedelphia, PA, you will have the flexibility to work remotely* as you take on some tough challenges. May need to travel to locations at time.
Primary Responsibilities:
- Positions in this function include RN roles (with current unrestricted licensure in applicable state) responsible for providing clinical expertise in any of the following areas:
- 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
- Generally, work is self-directed and not prescribed
- Works with less structured, more complex issues
- Serves as a resource to others
- Assesses and interprets customer/patient needs and requirements
- Identifies solutions to non-standard requests and problems
- Solves moderately complex problems and/or conducts moderately complex analyses
- Works with minimal guidance; seeks guidance on only the most complex tasks
- Translates concepts into practice
- Provides explanations and information to others on difficult issues
- Coaches, provides feedback, and guides others
- Acts as a resource for others with less experience
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.
Required Qualifications:
- Undergraduate degree or equivalent experience. Preferred-BSN, Pharmacist, Pharmacy Technician, or equivalent clinical health care experience
- 2+ years of Hospital and/or Clinic based nursing/pharmacy experience
- Ability to travel up to 25%
Preferred Qualifications:
- Current, unrestricted RN license in the state of practice
- 2+ years of home healthcare experience, preferably in IG infusion
- Appeal submission experience
- Knowledge of the Infusion Nursing standards (INS) and nursing process
- Authorization and payer knowledge
- Neurology and/or Immunology background
- Located somewhere between Cleveland, OH and Pittsburg, PA
- Demonstrated effective communication and teaching skills with patients, family members, and other staff members
- Demonstrated ability to work autonomously, managing own workload and seeking out opportunities to expand service opportunities
Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you’ll fill far more than prescriptions. As a member of one of our pharmacy teams, you’re empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves 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: 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.