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Clinical Letter Review LPN - Optum West Remote

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About the position

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.

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
  • Perform 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

Requirements

  • 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

Nice-to-haves

  • 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

Benefits

  • Comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution
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