US Registered Nurse w/ Hospital Bedside Experience | Hybrid

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<p><strong>US REGISTERED NURSE WITH HOSPITAL BEDSIDE EXPERIENCE | HYBRID</strong></p><p></p><p><strong>ROLE AND RESPONSIBILITIES</strong></p><ul><li><p>Function is responsible for performing pre-service clinical coverage review of services that require notification, using applicable benefit plan documents, evidence-based medical policy and nationally recognized clinical guidelines and criteria. Determines medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination.</p></li><li><p>Conduct Non-Clinical Research to Support Determinations. Determine that the case is assigned to the appropriate team and health plan for review (e.g., Medicare, Medicaid, Commercial, Dual Special Needs Plan)</p></li><li><p>Review Existing Clinical Documentation. Review/interpret clinical/medical records submitted from provider (e.g., office records, test results, prior operative reports)</p></li><li><p>Make Final Determinations Based on Clinical and Departmental Guidelines. Understand and adhere to applicable legal/regulatory requirements (e.g., federal/state requirements, HIPAA, CMS, NCQA/URAC accreditation)</p></li><li><p>Achieve and Maintain Established Productivity and Quality Goals. Adhere to relevant quality audit standards in performing reviews, making determinations and documenting recommendations.</p></li></ul><p>Your role is critical in allowing our members, families, facilities and health professionals to have greater confidence in the exceptional care we provide. And for you, an everyday opportunity to do your life’s best work.</p><p></p><p><strong>JOB QUALIFICATIONS</strong></p><ul><li><p><strong>Valid and unrestricted USRN license and PHRN License required</strong></p></li><li><p><strong>Must have a minimum of 2 years hospital (bedside)  experience (ICU, ER, Medical Surgical, OR)</strong></p></li><li><p>Clinical competence in understanding hospital care and care coordination</p></li><li><p>Knowledge in computer navigation</p></li></ul><p><strong>WHAT WE OFFER</strong></p><ul><li><p>Market Total Rewards Package</p></li><li><p><strong>Retirement Plan</strong></p></li><li><p><strong>Medical Plan (HMO) from Day 1 of employment</strong></p></li><li><p><strong>Temporary Work at Home set-up</strong></p></li><li><p>Dental, Medical, and Optical Reimbursements</p></li><li><p>Life and Disability Insurance</p></li><li><p>Paid Time-Off Benefits</p></li><li><p>Sick Leave Conversion</p></li><li><p>Tuition Fee Reimbursement</p></li><li><p>Employee Assistance Program (EAP)</p></li><li><p>Annual Performance Based Merit Increases</p></li><li><p>Employee Recognition</p></li><li><p>Training and Staff Development</p></li><li><p>Employee Referral Program</p></li><li><p>Employee Volunteerism Opportunity</p></li><li><p>All Mandatory Statutory Benefits</p></li></ul><p><strong>WHO WE ARE</strong></p><ul><li><p><strong>Optum </strong>is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.</p></li><li><p><strong>UnitedHealth Group </strong>is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.</p></li><li><p>We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.</p></li><li><p>As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.</p></li><li><p>We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.</p></li><li><p>Elevate your career with a leading health care company while improving lives.</p></li></ul><p>Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to <strong>Caring. Connecting. Growing together</strong></p>

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...