Optum Logo

Optum

RN Concurrent Review - UM - Remote - Kelsey Seybold Clinic

Posted Yesterday
Be an Early Applicant
In-Office or Remote
Hiring Remotely in Pearland, TX
60K-107K Annually
Senior level
In-Office or Remote
Hiring Remotely in Pearland, TX
60K-107K Annually
Senior level
The Concurrent Review Case Manager monitors medical treatment, ensures adherence to guidelines, and manages discharge processes for patient care. Responsibilities include telephonic monitoring and collaboration with physician leadership.
The summary above was generated by AI
Requisition Number: 2362466
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.
The Concurrent Review Case Manager is responsible for telephonic monitoring and the documentation of medical treatment and comparing it to established criteria to determine if treatment meets established guidelines. In addition, the Concurrent Review Case Manager monitors patients progress toward recovery for early identification of continuing care needs in an attempt to facilitate discharge for specified populations. This position works closely with Medical Management Physician leadership and various internal departments
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
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:
  • Associate Degree in Nursing or higher
  • Active Texas RN license or multistate compact RN license
  • 5+ years of nursing experience in concurrent review
  • Managed Care knowledge

Preferred Qualifications:
  • Certification in area of specialization, BSN
  • ACP certification
  • Case Management Certification
  • 2+ years in area of specialization, 2+ years of Case Management/Utilization Review experience
  • Proven program development skills
  • Proven communication and problem-solving skills; Computer literate

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Similar Jobs at Optum

Yesterday
Remote
Texas, USA
14-24 Hourly
Entry level
14-24 Hourly
Entry level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
As a Hospice CNA, you will assist clients with personal hygiene, daily living activities, meal prep, and monitor their condition. You'll ensure a safe environment and help clients maintain their independence in their homes.
Yesterday
In-Office or Remote
92K-164K Annually
Senior level
92K-164K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Analyze financial impacts of provider contracts and reimbursement strategies while leading complex pricing projects. Collaborate with stakeholders to optimize network pricing and contract methodologies, providing mentorship and insights based on extensive analytical experience.
Top Skills: ExcelPower Pivot
Yesterday
In-Office or Remote
20-36 Hourly
Senior level
20-36 Hourly
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Utilization Review Specialist (LVN) conducts medical reviews, verifies benefits, applies medical necessity criteria, and communicates with providers regarding authorizations and pre-certifications.
Top Skills: HmoMultistate Compact Rn LicensePos Insurance KnowledgePpoTexas Rn License

What you need to know about the Chicago Tech Scene

With vibrant neighborhoods, great food and more affordable housing than either coast, Chicago might be the most liveable major tech hub. It is the birthplace of modern commodities and futures trading, a national hub for logistics and commerce, and home to the American Medical Association and the American Bar Association. This diverse blend of industry influences has helped Chicago emerge as a major player in verticals like fintech, biotechnology, legal tech, e-commerce and logistics technology. It’s also a major hiring center for tech companies on both coasts.

Key Facts About Chicago Tech

  • Number of Tech Workers: 245,800; 5.2% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: McDonald’s, John Deere, Boeing, Morningstar
  • Key Industries: Artificial intelligence, biotechnology, fintech, software, logistics technology
  • Funding Landscape: $2.5 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Pritzker Group Venture Capital, Arch Venture Partners, MATH Venture Partners, Jump Capital, Hyde Park Venture Partners
  • Research Centers and Universities: Northwestern University, University of Chicago, University of Illinois Urbana-Champaign, Illinois Institute of Technology, Argonne National Laboratory, Fermi National Accelerator Laboratory

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account