Remote RN: Medicaid Appeals Clinical Coordinator

UnitedHealth Group; Town of Texas (WI); A distancia; USD 40.000 - 72.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Comprehensive benefits package

Equity stock purchase

401k contribution

Descripción de la vacante

UnitedHealth Group is seeking an HSS Clinical Coordinator RN to conduct clinical reviews and evaluations related to Medicaid appeals, ensuring compliance and accuracy in assessments. This remote role is ideal for experienced RNs seeking meaningful patient-care impact.

You will review medical records, identify discrepancies, provide clinical judgment on medical necessity, and document findings. The position is full-time, daytime, with residency in Texas required.

Formación

• Active Texas RN license required.
• 2+ years Medicaid experience.
• Experience reviewing H6516/H2060 assessments.
• Ability to work remotely Mon-Fri.

Responsabilidades

• Conduct comprehensive clinical reviews of appealed determinations.
• Evaluate medical records and supporting clinical evidence.
• Identify discrepancies impacting initial assessments.
• Provide independent clinical judgment on medical necessity.
• Prepare detailed appeal findings and documentation.
• Collaborate with team and maintain auditable records.
• Work from home Monday - Friday with daytime hours.

Conocimientos

RN license

Medicaid experience

Clinical reviewing

Auditing skills

Educación

Nursing degree (RN)

Descripción del empleo

UnitedHealth Group is seeking an HSS Clinical Coordinator RN to conduct clinical reviews and evaluations related to Medicaid appeals, ensuring compliance and accuracy in assessments. This remote role is ideal for experienced RNs seeking meaningful patient-care impact.

You will review medical records, identify discrepancies, provide clinical judgment on medical necessity, and document findings. The position is full-time, daytime, with residency in Texas required.