Description

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

The RN Tele-Health Triage is a registered nurse who is responsible for incoming calls and transferred calls from patients, physicians, and healthcare organizations. Using nursing knowledge and departmental protocols, the Primary Care at Home Desk RN will assess the patient and will follow triage guidelines and protocols to offer appropriate options for care. The RN will escalate concerns/high acuity cases according to guidelines to Primary Care at Home providers and medical director. The Primary Care at Home Desk RN will document appropriately in EPIC to ensure accurate departmental record keeping.

The Primary Care at Home Desk RN will facilitate referrals to primary care providers, specialists, healthcare facilities, community resources, and facilities. Supports benefit verification and prior authorizations for health care services/procedures that require authorization per payor/plan requirements. Collects pertinent information needed for medical review from referring provider to ensure service decisions are determined within appropriate timeframes.

The Primary Care at Home Desk RN will own and modify triage and authorization workflows and will educate staff about triage and authorization processes. The Primary Care at Home Desk RN will be flexible and adapt to changes in policy and procedures, new techniques, and additional responsibilities as assigned to meet changing business needs.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

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:

• Associates of Science in Nursing
• RN from an approved school of nursing with current license to practice professional nursing in the State of Texas
• 5+ years of total progressive clinical RN experience for adult and/or pediatric patients
• 2+ years of experience with capitated payment arrangements
• 1+ years of experience specifically working with insurance (HMO, PPO, and POS) companies to obtain authorizations and precertification for medical services
• Experience with EMRs and medical records
• Familiarity and application of CPT, ICD, and HCPS codes
• Basic PC skills including Windows Operating System
• Typing skills of 30 WPM
• Proven excellent communication skills
• Proven ability to multi-task and prioritize responsibilities
• Ability to travel throughout the greater Houston area to facilities and patient homes. Must have reliable transportation and current insurance coverage

Preferred Qualifications:

• Bachelor of Science in Nursing
• Certified Coder
• 2+ years in ambulatory/primary care setting.
• Experience with EPIC EMR

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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 hourly pay for this role will range from $29 - $52 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

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.