Clinical Research Analyst RN Specialist

hace 2 semanas


San Juan, San Juan, Puerto Rico UnitedHealth Group A tiempo completo
Overview

UnitedHealth Group, a global leader in healthcare, empowers individuals to live healthier lives by connecting people with care, pharmacy benefits, data, and resources. As a Clinical Investigation Analyst RN, you will play a vital role in improving health outcomes by analyzing medical records and identifying opportunities for cost savings.

This position offers a dynamic work environment where you can utilize your clinical expertise to drive business growth while promoting a culture of diversity, inclusion, and innovation.

About the Job

We are seeking a skilled Clinical Investigation Analyst RN who will be responsible for reviewing medical records to ensure accurate billing practices. You will exercise judgment and decision-making skills to analyze complex payment decisions, adhering to state and government compliance guidelines and company policies.

Your key responsibilities will include:

  • Investigating and reviewing claims to identify errors and waste, recommending providers for review and working with analytics to increase line of business savings.
  • Identifying opportunities for clinical analytics and participating in projects necessary to achieve client objectives.
  • Maintaining daily case review assignments with high accuracy and providing clinical explanations to providers.

You will also participate in provider/client/network meetings, provide education through written communication, and participate in additional projects as needed.

Required Skills and Qualifications

To succeed in this role, you will need:

  • A valid, active, and unrestricted RN license.
  • Intermediate Windows PC navigation proficiency and ability to navigate multiple systems.
  • Professional proficiency in both English and Spanish.

Certified coder certifications such as AHIMA or AAPC are highly valued, but not required.

Benefits

As a member of our team, you will enjoy:

  • A competitive salary of $60,000 - $80,000 per year, based on location and experience.
  • A comprehensive benefits package, including medical, dental, and vision insurance.
  • Opportunities for career growth and professional development.
  • A dynamic work environment that promotes diversity, inclusion, and innovation.
About UnitedHealth Group

At UnitedHealth Group, we are committed to creating a healthier world by advancing health equity, improving health outcomes, and reducing costs. We believe in fostering a culture of diversity, inclusion, and innovation, and we strive to make a positive impact on the communities we serve.



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