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RN Auditor La Palma CA

Company: UnitedHealth Group
Location: Buena Park
Posted on: June 23, 2022

Job Description:

***$7,500 Sign On Bonus for External Candidates***Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)The Clinical Services Auditing and Training Specialist is an experienced clinician that will act as a teacher and mentor to other clinical staff. This position provides education and coaching on patient assessment, patient care, and computer documentation. The Clinical Services Auditing and Training Specialist performs regular audits of all disciplines and provide feedback and opportunities identified to the Senior Director of Clinical Services. This position can work independently in directing patient needs by virtue of his/her experience and the competencies required for this position. This position will review detailed clinical information, analyze, and interpret clinical documentation, determine relevance, and make clinically sound conclusions and recommendations to leadership to elicit change and improvement.If you are located in La Palma, CA, you will have the flexibility to telecommute* as you take on some tough challenges.Primary Responsibilities:

  • Responsible for the development and maintenance of all training materials and job aids
  • Reviews the work of others and identifies opportunities
  • Serves as a subject matter expert
  • 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)
  • Provides strategic oversight and support to clinical services team
  • Educate others regarding guidelines (e.g. MCG and CMS)
  • Provide feedback / information to internal and external customers
  • Develops and updates new Policies & Procedures that support company and departmental standards, procedures, and strategic directives as necessary
  • Clinical Training (planning, coordinating, delivering, and evaluating clinical training)
  • Other duties as assignedYou'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:
    • AA in Nursing
    • Valid and unrestricted RN license in CA
    • 5+ years of acute clinical nursing experience (telephonic, inpatient acute case management, or floor)Preferred Qualification:
      • BSN
      • 3+ years of UM experience in managed care environment preferably as a Case Manager
      • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodationTo protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment. Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)**PLEASE NOTE** The Sign-On Bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.*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.

Keywords: UnitedHealth Group, Buena Park , RN Auditor La Palma CA, Healthcare , Buena Park, California

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