Full Time Optum Utilization Review Jobs in Raleigh, NC

$40,000 Student Loan Repayment Or $25,000 Sign-on Bonus 

This role requires travel across the entire state of North Carolina, approximately 85% of the time. All travel expenses are covered, and there is likewise a base salary plus multiple incentives.  You can live anywhere in the state for this role. 

In this role, you will have the ability to achieve work life balance. Flexible scheduling is offered where providers can flex their time between 8am-8pm over the 7-day work week.  No on-call, no weekends and no holidays required.

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum HouseCalls team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together.

HouseCalls is an innovative, performance-driven program that brings care directly to members' homes. As a HouseCalls Advanced Practice Clinician (Nurse Practitioner or Physician Assistant), you will conduct annual in-home health assessments for Medicare Advantage and other plan members. This is a non-prescribing, field-based role focused on improving health outcomes through education, gap closure, and collaboration with primary care providers (PCP).

Primary Responsibilities:

• Conduct comprehensive in-home assessments, including:
  • Past medical history review, medication reconciliation, vital signs, and physical exam
  • Evidence-based screenings and point-of-care testing (as appropriate)
• Identify and document diagnoses for care management and treatment planning
• Communicate findings to members' PCPs to address gaps in care
• Recognize urgent/emergent situations and intervene appropriately
• Educate members on disease processes, medications, and compliance
• Address social determinants of health and provide referrals as needed

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:

• For NPs: Active ANCC or AANP certification in Family, Adult, Geriatric, or Adult-Gerontology Primary Care
• For PAs: Current NCCPA certification and state licensure
• Active, unrestricted licensure in the state you will be practicing in (or ability to obtain by start date) without current disciplinary actions or practice limitations
• Active and unrestricted driver's license
  • In addition to a driver's license, access to reliable transportation to complete home visits
• Ability to navigate varied home environments; ability to sit/stand/kneel as needed to perform assessments 
• If you're working in a state that allows NPs/PAs to practice independently (without Collaborative Agreement), you must get approval from your licensing board-if required. New hires who are eligible but haven't applied yet must do so within 1 month of starting. If you're not eligible at the time of hire, you must begin working toward eligibility within 1 month and apply for approval within 3 months of becoming eligible

Preferred Qualifications:

• 1+ years of clinical experience (family, geriatric, or home health preferred)
• Proficiency with electronic medical records and technology
• Ability to transport equipment weighing up to 30 pounds and navigate stairs as part of home visits
• Proven communication skills with geriatric or Medicare populations

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 $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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. 

OptumCare 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.