Remote Utilization Management Nurse: Appeals & Reviews

Registered Nurse; Northern (KY); Hybrid; USD 40,000 - 72,000; Part time

Job summary

Optum is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters. The role requires an RN license, 3+ years bedside experience, and strong data extraction skills. You will work per diem with flexible start times and may telecommute from anywhere in the United States.

Responsibilities include HIPAA compliance, collaboration with OPAS/Optum teams, and maintaining high quality reviews. Microsoft Office proficiency and 45 wpm typing are required.

Qualifications

• Associate's degree required.
• Unrestricted RN license in your state.
• 3+ years bedside nursing in ED/telemetry/ICU/CCU.
• Advanced proficiency with Microsoft Office and related software.
• Ability to type 45 wpm.

Responsibilities

• Compose appeal letters with data extraction and templates.
• Ensure HIPAA confidentiality compliance.
• Support and promote Optum and OPAS goals.
• Build relationships with clients and teams.
• Maintain quality and productivity standards.
• Attend meetings and contribute to deliverables.

Skills

Microsoft Office

Typing 45 wpm

Communication skills

Education

Associate's degree

Tools

Microsoft Word

Job description

Optum is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters. The role requires an RN license, 3+ years bedside experience, and strong data extraction skills. You will work per diem with flexible start times and may telecommute from anywhere in the United States.

Responsibilities include HIPAA compliance, collaboration with OPAS/Optum teams, and maintaining high quality reviews. Microsoft Office proficiency and 45 wpm typing are required.