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Clinical Letter Review LPN - Optum West 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.
This position is full-time (40 hours/week). Employees are required to have flexibility to work any shift schedules during normal business hours in Pacific or Mountain time zone, to include weekend coverage.\'
You\'ll enjoy the flexibility to work remotely,* as you take on some tough challenges.
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 (LMA\'s) 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
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:
- 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 experience
- Knowledge of medical terminology
- Proven basic computer skills
- Proven comfortable working with medical directors
- Proven solid interpersonal, oral, and written communication skills
- Proven excellent written skills - grammar and punctuation
- Proven to be detail oriented
Preferred Qualifications
- 3+ years of direct clinical patient care experience
- 1+ years of experience with medical management activities in a managed care environment
- Knowledge of managed care principles
*All employees working remotely will be required to adhere to UnitedHealth Group\'s Telecommuter Policy
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, you\'ll find a far-reaching choice of benefits and incentives.
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.
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.
#J-18808-Ljbffr Experience: 3 years required