Private Duty Nurse RN
Company: UnitedHealthcare
Location: Richmond
Posted on: December 1, 2025
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Job Description:
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. The Private Duty Nurse Care Manager (RN) will be
responsible for the overall management of a sub-population of
DMAS-identified Mandatory High Priority members who must receive
High Intensity care management and preforming pre-service clinical
reviews of Home & Community Based Services HCBS). If you reside
within a commutable distance from the Central Virginia area, you
will have the flexibility to work remotely* as you take on some
tough challenges. Primary Responsibilities: - Meeting contractual
requirements related to Initial HRA, MMHS Screening, ICPs, ICT, and
minimum mandatory contacts - Conducting face-to-face visits -
Oversight of PDN authorizations, including Utilization Management
aspects of the authorization process - Oversight of HCBS UM
authorizations - Participate in PDN Pod Rounds - Provide primary
case management across the continuum for these medically fragile
and complex members to include following members through inpatient
hospitalizations, assisting with transitions of care, and
coordinating HCBS service needs (DME, EM/AT, PC/AC hours, and PDN
hours) - Serve as lead contributor to the oversight of and
accountability for member-specific quality measures (HEDIS, NCQA)
(will have support and assistance from Quality Department) This is
a field-based role that will require travel approximately 50% of
the time in the field within an assigned coverage area. Candidates
must be willing to travel throughout the state of Virginia;
primarily in the Central Virginia area. 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: - Bachelor's
degree in nursing - Current, unrestricted RN license for the state
of Virginia - 1 years of care coordination and/or work in a
healthcare environment - 1 years of private duty nursing, trach,
ventilator, ICU/stepdown, pediatric home health, NICU or pediatric
nursing experience - Demonstrated competence in applying processes
designed to ensure adherence to all pertinent federal and state
rules and regulations - Sensitivity to the special needs of
children who rely on technology and their families, to include
understanding the stress and challenges they may experience - Prior
performance in meeting requirements for HRA completion, managing
members with complex health care needs, and ability to manage
complex workload - Driver's license and access to reliable
transportation Preferred Qualifications: - Experience with PDN
authorizations - Experience with LTSS authorizations - Experience
with Case Management - Experience with Pediatric Home Health or
Private Duty Nursing Soft Skills: - Excellent problem-solving
ability, organizational skills, and capacity to work independently
or as a team - Excellent work ethic and attention to detail -
Understanding of the importance of bringing quality considerations
into every touch point *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 $28.27 to
$50.48 per hour based on full-time employment. We comply with all
minimum wage laws as applicable. UHCPJ 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.
Keywords: UnitedHealthcare, Richmond , Private Duty Nurse RN, Healthcare , Richmond, Virginia
