Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Utilization Review Nurse, RN is responsible for providing clinically efficient and effective Inpatient utilization management. Reviews inpatient criteria for acute hospital admissions and concurrent review and or prior authorization requests for appropriate care and setting by following evidence based clinical guidelines, medical necessity criteria and health plan guidelines. Reviews and applies hierarchy of criteria to all inpatient admission and preauthorization requests from providers that require a medical necessity determination. Is involved in assuring that the patient receives high-quality cost-effective care. Uses sound clinical judgement and managed care principles in the coordination of care. Prepares any case that does not meet medical necessity guidelines for medical appropriateness of procedure, service or treatment for review with the Medical Director for a decision. The shift is Monday through Friday 8am-5pm in Pacific Time Zone. Occasional participation in weekend rotation is required. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Maintains clinical expertise and knowledge of scientific progress in nursing and medical arena and incorporates this information into the clinical review and care coordination processes - Performs clinical review for appropriate utilization of medical services by applying appropriate medical necessity criteria guidelines - Authorizes healthcare services in compliance with contractual agreements, Health Plan guidelines and appropriate medical necessity criteria - Documents clinical reviews in care management system. Provide accurate and timely documentation and supporting rational of decision in care management system - Utilizes care management system and resources to track and analyze utilization, variances and trends, patient outcomes and quality indicators - Research and prepares clinical information for case review with Physician Leadership for patient treatment and care planning - Utilizes knowledge of resources available in the health care system to assist the physician and patient effectively - Identifies members who are appropriate for care coordination programs and collaborates with the Medical Management team for care coordination of the member’s needs along the continuum of care - Successfully completes the Interrater Reliability Testing to ensure consistency of review and application of criteria - Meets timeliness standards for decision, notification, and prior authorization activities - Serves as an advocate for all providers and their patients - Demonstrates a positive attitude and respect for self and others and responds in a courteous manner to all customers, internal and external - Maintains the confidentiality of all company procedures, results, and information about patients, contracts, and all other proprietary information regarding Optum business - Performs other duties as required or requested in a positive and helpful manner to enable the department to achieve its goals 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: - Current unrestricted Registered Nurse (RN) license in state of residence - Registered Nurse license in the state of California or the ability to obtain within 90 days of hire - 3+ years of clinical nursing experience in acute care hospital or LTAC setting - 1+ years of Utilization Management experience in hospital or insurance setting - Experience applying Medicare and/or Medicaid guidelines - Experience with Milliman (MCG) or InterQual guidelines - Experience researching and preparing clinical information for case review with Physician Leadership for patient treatment and care planning - Experience providing accurate and timely documentation of clinical review and supporting rational of decision in care management systems - Experience employing analytical skills necessary for quality case management, utilization review, and quality improvement to meet organizational objectives - Experience using various computer software applications with an intermediate level of competence, including Microsoft Word and Excel - Ability to work Monday-Friday 8am-5pm in Pacific Time Zone and participate in weekend and holiday rotation Preferred Qualifications: - Inpatient Utilization Management experience - Utilization Management experience for insurance or managed care organization - Prior Authorization experience - Emergency Room clinical experience - Primary residence in Pacific Time Zone - Current and unrestricted RN license in California *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 salary for this role will range from $60,200 to $107,400 annually 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. UnitedHealth Group 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. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

At Mukuru, great ideas only matter if they’re delivered well. As a Portfolio Coordinator, you’ll be the engine behind how projects move from concept to completion ensuring structure, visibility, and impact across the business. Why this role matters You’ll sit at the centre of our project ecosystem, connecting teams, processes, and data. Your work will ensure that strategic initiatives, operational priorities, and governance standards all come together seamlessly helping us deliver better, faster, and smarter. What you’ll do Keep the portfolio moving - Coordinate projects across business areas, ensuring alignment with PMO frameworks and standards - Track project progress from intake to delivery, identifying risks, delays, and gaps - Maintain a single source of truth for all project data and reporting Own governance and structure - Ensure compliance with stage-gates, documentation, and delivery practices - Support project intake, validate submissions, and maintain high-quality artefacts - Drive consistency in how projects are managed across the organisation Be the Asana expert - Act as the go-to Asana Champion, ensuring data accuracy and usability - Optimise workflows, boards, and reporting structures - Support automation, clean-up, and continuous improvement of the platform Support critical initiatives - Coordinate Business Continuity Planning (BCP) and OHS initiatives - Maintain registers, track progress, and ensure audit readiness - Support strategic and operational projects when needed Drive insight and improvement - Build reports and dashboards that give leadership clear visibility - Identify opportunities to improve PMO processes and governance maturity - Coach teams on best practices and help embed strong delivery discipline What you bring - 3–5 years’ experience in project/portfolio/PMO coordination - Strong working knowledge of project management methodologies - Hands-on experience with Asana, Excel, or similar tools - Excellent organisational skills with the ability to manage multiple priorities - Strong communication skills and confidence working with cross-functional teams What sets you apart - Highly detail-oriented with a passion for structure and organisation - A natural collaborator who can connect people and processes - Proactive mindset—you spot gaps and fix them before they become problems - Comfortable working in a fast-paced, evolving environment - Interest in fintech, operations, and large-scale project delivery I am sure you are reading this job description and meet majority of the criteria BUT you may also still not be 100% comfortable in applying. We believe that there is a place for everyone under the Mukuru sun and we want YOU to contribute to our diverse tapestry of talent. So come on, take a leap of faith, and send your application if you meet majority of our requirements. Remember to include a snippet of how you will bring value and help us build a future of success that will help us determine where and how you may best be suited” Maybe you are just the future Mukurian we need!! Should you be appointed in a remote/work from home role at Mukuru, it is your responsibility to ensure that you have uninterrupted internet connectivity and a ‘work-like’ environment at your home location, in order to deliver your best in terms of performance, productivity and service to our customers. If you do not receive any response after two weeks, please consider your application unsuccessful. NB: ALL STAFF APPOINTMENTS WILL BE MADE WITH DUE CONSIDERATION OF THE COMPANY’S DIVERSITY AND INCLUSION PLANS

Explore opportunities with Atrius Health, part of the Optum family of businesses. We’re an innovative health care leader and multi-specialty group practice, delivering an effective, connected system of care for adult and pediatric patients at 28 practice locations in eastern Massachusetts. Our entire team of providers (physicians, PA/NPs and ancillary clinicians) works collaboratively with a value-based philosophy within our group practice as well as with hospitals, rehab and nursing facilities. Be part of our vision to transform care and improve lives by building trust, understanding and shared decision-making with every patient. Join us and discover the meaning behind Caring. Connecting. Growing together. Position in this function is responsible for providing on-site transitional care coordination to ensure safe transitions of care and optimal communication between treating facility, Patient/Family and Atrius Health. Responsible for coordinating patient transitions from Hospital to home or other care settings, ensuring a smooth discharge process and continuity of care Position Details: - Location: Remote (MA residents only) - Department: Utilization Management - Schedule: 40HRS Weekly M-F 8:00am- 4:30pm If you are MA licensed RN, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: - Provides direct referral source servicing at identified facility, building and enriching relationships, identifying needs, problem solving and meeting or exceeding expectations of external customers - Serves as an extension of the Atrius Health practice site, connecting with Atrius Health patients and/or families to bridge the Atrius Health practice to the patient - Conducts review of the medical record for Atrius Health adult medical or surgical hospitalized patients - Conducts initial assessment of patient within 24 – 48 hours (business days of admission) - Subsequent review/progress note at least every 7 days or accompanying a change in condition/plan - May provide educational and/or program material to the site facility staff in compliance with Atrius Health clinical initiatives, services and specialty programs - Performs needs assessments of patients/families for services including but not limited to primary care, specialty care visits, skilled homecare, palliative care, hospice care (including hospice residence), and/or skilled nursing facility, to ensure appropriateness of services and expedite transitions of care - Educates Atrius Health patients/families regarding provider relationships serviced through preferred homecare/SNF organizations - Assesses adult medical/surgical Atrius Health patients for risk of readmission, and communicates identified risks with transition of care, outpatient case manager and/or primary care team - Facilitates real-time review of contributing factors to readmission of patients and explores opportunities for acute care hospitalization (ACH) reduction - Accesses Atrius Health patient’s Epic medical record to determine current program enrollment for continuation of care - Assesses patients admitted with Heart Failure (HF) or Chronic Obstructive Pulmonary Disease (COPD) for HTM/RPM and initiates referral to the appropriate program - Initiates a referral to the Atrius health heart failure program when appropriate - Collaborates with hospital-based case manager to facilitate advance care planning documents such as health care proxy or MOLST form - Facilitates communication between patient’s hospital-based care team and practice based primary care team when needed or requested - Collaborates with transition of care team and hospital-based case manager to ensure post-hospital follow up visit is scheduled - Provides supportive patient/family education for targeted diagnoses including heart failure, diabetes, COPD to ensure optimal preparation for home discharge - Coordinates with the hospital-based case manager to facilitate regarding Atrius Health preferred provider networks - Seeks opportunities to improve communication and collaboration amongst all clinical partners in patient care treating facility and internal/external partners or provider - Collaborates and communicates with Manager and Atrius Health Case Manager to identify and address any issues or concerns - Documentation: Maintains accurate records of the discharge planning process in the patient's medical record for legal, regulatory, and billing purposes - Participates in service recovery as needed - Promotes problem identification, resolution to barriers in care delivery, efficiency, productivity and customer satisfaction - Builds relationships with physicians, referral sources, managed care and assigned facility(ies) - Provides information, resource materials and education to all providers and case managers and solicits feedback - Promotes Atrius Health specialty programs designed to meet the needs of patients, providers, and partners - Assists with other referral source account coverage as needed - Performs other duties as requested 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: - Graduate of a State-approved school of nursing - Current, unrestricted, license to practice professional nursing in the Commonwealth of Massachusetts - American Heart Association Basic Life Support (BLS) - Electronic medical record (EMR) experience and/or aptitude to master the EMR based on other technology experience - Demonstrated proficiency using multiple software applications, including MS Office, EXCEL, Cloud based platforms and EPIC reporting workbench and dashboards - Demonstrated solid critical thinking, problem solving, interpersonal and patient interviewing skills - Demonstrated excellence in practice, documentation, and cost-effective care utilization Maintains high patient satisfaction - Demonstrated ability to interpret clinical information, assess the implication of treatment and develop and implement a plan of care - Demonstrated ability to interpret clinical information, apply UM criteria and health plan guidelines for decision making - Demonstrated ability to work effectively in a faced paced team environment Preferred Qualifications: - Bachelor of Science in Nursing (BSN) - Certification in Case Management (CCM) or CCM eligible preferred - 3+ years in utilization management or case management - 3+ years clinical experience with home health care experience or strong knowledge base in home health and hospice care Other Requirements: - Able to use all electronic tools and applications relevant to the performance of the duties of the position, including but not limited to phone, keyboard, computer and computer applications - Able to work in multiple locations and cover multiple primary care practices as needed - Performs all job functions in compliance with applicable federal, state, local and company policies and procedures Accesses only the minimum necessary protected health information (PHI) for the performance of job duties Actively protects the confidentiality and privacy of all protected health information they access in all its forms (written, verbal, and electronic, etc) taking reasonable precautions to prohibit unauthorized access Complies with all Atrius Health and departmental privacy policies, procedures and protocols Follows HIPAA privacy guidelines without deviation when handling protected health information Working Conditions / Physical Demands - Busy clinical environment with frequent deadlines and interruptions - May require some weekend or holiday coverage *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 $28.94 to $51.63 per hour 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.

Manages teacher performance, developing and providing necessary training to support their professional development; Manages Master and Lead Teachers and programs.