Gainesville, Georgia
Wilmington, Delaware
Posted: 18-Dec-24
Location: El Segundo, California
Categories:
Internal Number: 145267802
Optum is seeking a Clinical Grievances LVN to join our team in El Segundo, CA. Optum is a clinician-led care organization that is changing the way clinicians work and live.
As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.
At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.
If you have the abilty to work during PST Work hours, you will have the flexibility to work remotely* as you take on some tough challenges.
Position Highlights & Primary Responsibilities:
As the Clinical Grievances Nurse, you will be responsible for reviewing incoming member cases to determine if the appropriate care was given.
- Reviews health plan grievances and assigns an appropriate severity level and issue code.
- Create written documentation of quality of care findings, using effective clinical writing skills (e.g., inquiry letters, case summaries)
- and upload into applicable system
- Prepares cases for peer review committee
- Coordinates case reviews with the QI coordinator
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:
- Current LVN license in the state of California
- 2+ years of Clinical Nursing experience in an acute inpatient setting
- Grievance and or Quality Improvement experience
- Proven solid clinical assessment skills
Preferred Qualifications:
- Inpatient Case Management experience
- Managed Care work experience
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
California Residents Only: The hourly range for California residents is $23.22 to $45.43 per hour. 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.
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.
