RN Full-time
UnitedHealthcare

Clinical Grievances RN - Remote in PST

UnitedHealthcare Phoenix, AZ, US
$28.94 - $51.63 / hour
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

As a Clinical Grievances Nurse, you will be responsible for reviewing incoming retrospective cases to determine if the appropriate care was given along with current cases to ensure the members immediate needs are being addressed. In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system.

If you are able to work PST hours, you'll enjoy the flexibility to work remotely* from anywhere in the U.S. as you take on some tough challenges. The working hours for this role are Monday - Friday, 8 am - 5pm PST or CST (Whichever time zone you are within).

Primary Responsibilities
  • Perform clinical assessment of healthcare services provided to our members for appropriateness
  • Understand relevant state and federal grievance and peer review requirements and accreditation standards applicable for processes supported
  • Receives cases from the QIS non- clinical team and reviews them against required clinical information, assessing for appropriateness and consulting with a Medical Director
  • Document relevant chronology of case review and provide rationale for severity level, descriptor codes, and any applicable Improvement Action Plan (IAP) implemented
  • Facilitate telephonic discussion with health care providers and/or members to obtain additional clinical information
  • Provide timely, quality service to members and providers while upholding UnitedHealthcare culture values
  • Act as a resource for others with less experience
  • Work independently and collaborating with Medical Directors and non-clinical partners
  • Function as a member of a self-directed team to meet specific individual and team performance metrics
  • Manage and maintain quality and productivity metrics

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 RN license in the state of residency
  • 3+ years of total RN experience including recent clinical experience in an inpatient / acute setting or similar setting
  • Demonstrated clinical documentation skills and critical thinking skills
  • Demonstrated proficiency in computer skills - Windows, Instant Messaging, Clinical Platforms, Microsoft Suite including Word, Excel, and Outlook
  • Designated workspace and access to install secure high speed internet via cable / DSL in home
  • Reside in and work 8 am-5 pm in Central or Pacific Standard time zone

Preferred Qualifications
  • Bachelor's in Nursing or higher
  • Experience with Managed Care Clinical Quality Programs
  • Case management experience
  • Clinical appeals and grievances experience
  • Audit / chart review experience
  • Experience in a telecommuting role
  • Ability to effectively utilize UHG applications, including but not limited to authorization applications, auto correspondence, and member & provider demographic systems

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.

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.

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

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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

RN Full-time
DaVita Kidney Care

Registered Nurse

DaVita Kidney Care Surprise, AZ
Posting Date 02/06/2026 14671 W MOUNTAIN VIEW BLVDSTE 102, SURPRISE, Arizona, 85374-4840, United States of America DaVita is seeking a Registered Nurse to join our outpatient dialysis team. In this role, you'll provide life-saving care to patients with end-stage renal disease or chronic kidney conditions. No dialysis experience required—just a commitment to compassionate, high-quality care. . Responsibilities: Deliver direct patient care in an outpatient dialysis setting Monitor patients, manage treatment plans, and respond to health changes Collaborate with a supportive clinical team, including Patient Care Technicians Educate patients and families on kidney health and treatment options Float to nearby clinics as needed; flexible schedule required What to Expect: Fast-paced, hands-on environment Long-term patient relationships Broad nursing skill application with medically complex patients Paid training provided Schedule: Flexible shifts including mornings, evenings, weekends, and holidays Training may occur at a clinic other than your home location Qualifications: RN license in the state of practice ADN required; BSN preferred Basic computer proficiency Reliable transportation for potential floating Preferred (Not Required): Experience in ICU, CCU, ER, or Med Surg CNN/CDN certification Benefits: Medical, dental, vision, and 401(k) match Paid time off and PTO cash-out Family support: EAP, Headspace, parental leave, backup child/elder care Career growth and tuition support Join DaVita and help patients live better, healthier lives. Apply today. DaVita gives preference to eligible and qualified applicants pursuant to the Navajo Preference in Employment Act. #LI-SV1 At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. This position will be open for a minimum of three days. For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.
RN Full-time
DaVita Kidney Care

Registered Nurse

DaVita Kidney Care Mesa, AZ
Posting Date 05/06/2026 301 South Power Rd, Mesa, Arizona, 85206, United States of America DaVita is seeking an organized, self-directed RN to manage Peritoneal Dialysis (PD) patients. You’ll educate patients and caregivers in-clinic, enabling them to perform dialysis independently at home. This role blends clinical care, patient education, and case management. Key Responsibilities: Train patients and caregivers on PD procedures and self-care Manage a caseload of PD patients, including assessments and care planning Monitor treatment progress, conduct home visits, and provide on-call support Collaborate with interdisciplinary teams to ensure safe, high-quality outcomes Schedule: Monday–Friday, 8-hour shifts Weekends and holidays off Flexible scheduling to manage your own caseload Requirements: RN license in the state of practice Valid driver’s license, insurance, and reliable transportation ADN required; BSN preferred Basic computer skills (MS Word, Outlook) Preferred Experience: Dialysis (PD, HHD, chronic, or acute) Patient education or teaching background Case management or telehealth experience CNN or CDN certification What We Offer: Medical, dental, vision, and 401(k) match Paid time off and PTO cash-out Mental health and family support (EAP, Headspace, parental leave, etc.) Paid training and ongoing professional development Empower patients to take control of their care. Make a meaningful impact—apply today. DaVita gives preference to eligible and qualified applicants pursuant to the Navajo Preference in Employment Act. #LI-SA1 At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. This position will be open for a minimum of three days. For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.
RN Full-time
American Vision Partners

Registered Nurse - Surgery

American Vision Partners Mesa, AZ
Company Intro At American Vision Partners (AVP) , we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible. Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. We are focused on building the nation’s largest and most comprehensive eye care practices and currently operate more than 100 eye care centers in Arizona, New Mexico, Nevada, California and Texas – including 25 ambulatory surgical centers. At AVP we value teamwork, providing exceptional experiences, continuous improvement, financial strength, and hard work. We are committed to providing best-in-class patient care, pioneering research and technology, and most importantly, rewarding and recognizing our employees! Overview As an Ophthalmology RN, your strong detail orientation and multi-tasking skills will be essential in our fast-paced, high-volume environment. You will provide a safe and efficient environment for all patients in our Ambulatory Surgical Center (ASC) during the perioperative phases Responsibilities Greets and admit patients to the pre-/post-operative area Assesses, plans, implements and evaluates patient care using the nursing process and take into account individual patient needs Prepares operating suite for patients - monitor cleanliness, assemble supplies, instruments and sutures, check equipment for proper functioning Assesses patient’s condition on arrival in surgery and provide physical or emotional support as needed Assists Anesthesia Provider and Surgeon during procedures, maintaining constant awareness of the operative situation and a safe environment for patients and personnel Evaluates, observes, and treats patients under local anesthesia Maintains accurate and complete records of patients’ surgical experience Starts IVs, gives medications, and prepares drugs and solutions per physician protocols Prepares for and manages immediate postoperative care, including transporting patients to recovery room, communicating patient needs, and providing patient and family training Assists in orientation of new team members and cross-training of existing personnel Obtains patient history through interviews and evaluations, noting data in chart and sharing pertinent information with physician Qualifications Associate’s degree required; BSN preferred Current RN License 1-year Ophthalmology experience as a Surgery RN is a plus BLS certification required ASC experience preferred Bilingual preferred Detailed oriented, reliable and able to multi-task in a fast-paced, high-volume work environment Excellent verbal and written communication skills This is a Safety Sensitive position Benefits & Perks Your health, happiness and your future matters! At AVP, we offer everything from medical and dental insurance, significant eye care discounts, child care assistance, pet insurance, continuing education funds, 401(k), paid holidays, PTO, Sick Time, opportunity for growth, and much more!
RN Full-time
Alumus Healthcare

Registered Nurse Sante FT Days

Alumus Healthcare Mesa, AZ
$36 - $44 / hour
Overview Elevate your career with a team that truly cares. Join a company that sees a better way for healthcare by being patient advocates, following evidenced-based clinical practices, caring for people holistically, improving continuity of care and providing nurturing surroundings that encourage and inspire. The Registered Nurse utilizes the nursing process to provide for optimum quality and continuity of nursing care to patients in the comfort of their home. Why Choose Santè? Lifelong Learning: We support lifelong learning and continuing education to keep your skills up to date with the most current principles in therapy. Upscale Facilities with Rooms designed for Privacy: Santè is known for its luxurious, state of the art surroundings and amenities. Some locations include private rooms and private bathrooms, chef cooked meals, coffee bars, world class exercise and therapy equipment. Opportunities for Growth: Many of our long-standing employees had humble beginnings and have grown their career with Santè. Comprehensive Benefits: Access to comprehensive benefit coverage plans to ensure your health and well-being are prioritized. Generous PTO: Enjoy ample paid time off to recharge and pursue personal endeavors, fostering a healthy work-life balance. Collaborative, Supportive Team: Join a team of passionate professionals dedicated to our core values, including prioritizing people, delivering exceptional customer experiences, embracing optimism, and executing best practices. Inclusive, Diverse Work Environment: Experience a workplace where every employee's unique contributions are celebrated and valued, fostering an environment of inclusivity and diversity. Responsibilities • Demonstrates the core nursing competencies established by the agency to ensure effective and efficient care on an ongoing basis.• Makes the initial evaluation visit and regularly reevaluates the patient’s nursing needs.• Initiates the plan of care and necessary revisions.• Provides those services requiring substantial specialized nursing skills.• Initiates appropriate preventive and rehabilitative nursing procedures.• Prepares clinical and progress notes for each patient visit and summaries of care conferenceson his/her patients in a timely manner as per Agency policy. Qualifications •Prior to date of hire, must hold a current, valid RN license or temporary RN license through the State Board of Nursing, or hold a compact RN license. Must maintain valid licensure to practice as a RN.•CPR required.•A minimum of one(1) year recent, verifiable experience as a licensed RN.•Recent licensed experience in LTC/SNF/Rehab strongly preferred. Benefits • Comprehensive benefits coverage including medical, dental, vision, life insurance, PTO and paid holidays, with 401(k) with match.• On Demand Pay – work a shift get paid the same day!• Employee Referral Bonus Program• Flexible Schedule• Tuition Assistance EEO EQUAL EMPLOYMENT OPPORTUNITY: It is the policy of our organization to provide employment opportunities to all persons based solely on ability, regardless of race, color, religion, sex, national origin, age, sexual orientation, gender identity or disability. When requested by a candidate, reasonable accommodations will be made in order for an otherwise qualified applicant with a disability to participate in any phase of the recruitment process. Please contact careers@alumus.com to request an accommodation. Requests should be made 24 hours in advance or as early as possible to allow time to arrange the accommodation. Pay Rate Pay Range USD $36.00 - USD $44.00 /Yr.
RN Full-time
Alumus Healthcare

Registered Nurse Sante of Mesa FT Days

Alumus Healthcare Mesa, AZ
$36 - $44 / hour
Overview Elevate your career with a team that truly cares. Join a company that sees a better way for healthcare by being patient advocates, following evidenced-based clinical practices, caring for people holistically, improving continuity of care and providing nurturing surroundings that encourage and inspire. The Registered Nurse utilizes the nursing process to provide for optimum quality and continuity of nursing care to patients in the comfort of their home. Why Choose Santè? Lifelong Learning: We support lifelong learning and continuing education to keep your skills up to date with the most current principles in therapy. Upscale Facilities with Rooms designed for Privacy: Santè is known for its luxurious, state of the art surroundings and amenities. Some locations include private rooms and private bathrooms, chef cooked meals, coffee bars, world class exercise and therapy equipment. Opportunities for Growth: Many of our long-standing employees had humble beginnings and have grown their career with Santè. Comprehensive Benefits: Access to comprehensive benefit coverage plans to ensure your health and well-being are prioritized. Generous PTO: Enjoy ample paid time off to recharge and pursue personal endeavors, fostering a healthy work-life balance. Collaborative, Supportive Team: Join a team of passionate professionals dedicated to our core values, including prioritizing people, delivering exceptional customer experiences, embracing optimism, and executing best practices. Inclusive, Diverse Work Environment: Experience a workplace where every employee's unique contributions are celebrated and valued, fostering an environment of inclusivity and diversity. Responsibilities • Demonstrates the core nursing competencies established by the agency to ensure effective and efficient care on an ongoing basis.• Makes the initial evaluation visit and regularly reevaluates the patient’s nursing needs.• Initiates the plan of care and necessary revisions.• Provides those services requiring substantial specialized nursing skills.• Initiates appropriate preventive and rehabilitative nursing procedures.• Prepares clinical and progress notes for each patient visit and summaries of care conferenceson his/her patients in a timely manner as per Agency policy. Qualifications •Prior to date of hire, must hold a current, valid RN license or temporary RN license through the State Board of Nursing, or hold a compact RN license. Must maintain valid licensure to practice as a RN.•CPR required.•A minimum of one(1) year recent, verifiable experience as a licensed RN.•Recent licensed experience in LTC/SNF/Rehab strongly preferred. Benefits • Comprehensive benefits coverage including medical, dental, vision, life insurance, PTO and paid holidays, with 401(k) with match.• On Demand Pay – work a shift get paid the same day!• Employee Referral Bonus Program• Flexible Schedule• Tuition Assistance EEO EQUAL EMPLOYMENT OPPORTUNITY: It is the policy of our organization to provide employment opportunities to all persons based solely on ability, regardless of race, color, religion, sex, national origin, age, sexual orientation, gender identity or disability. When requested by a candidate, reasonable accommodations will be made in order for an otherwise qualified applicant with a disability to participate in any phase of the recruitment process. Please contact careers@alumus.com to request an accommodation. Requests should be made 24 hours in advance or as early as possible to allow time to arrange the accommodation. Pay Rate Pay Range USD $36.00 - USD $44.00 /Yr.