Remote Utilization Management Nurse (RN)

Anacalifornia; Northern (KY); Hybrid; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group's Optum unit seeks a Utilization Management Nurse to review medical records and craft defensible appeal letters with attention to HIPAA and policy requirements. The role emphasizes timely, high-quality reviews of cases.

The position offers a 40-hour Monday–Friday schedule with telecommuting from anywhere in the U.S. and a competitive benefits package. Requires RN license, associate degree, and 3+ years bedside nursing in ED/ICU/telemetry.

Qualifications

• Associate's degree required.
• Unrestricted RN license in your state of residence.
• 3+ years bedside nursing experience in adult ED/Telemetry/ICU/CCU.
• Proficient with Microsoft applications and internet navigation.
• Ability to type 45 wpm.

Responsibilities

• Follows directive to compose appeal letters with data extraction and templates.
• Complies with HIPAA requirements and company policies.
• Support and promote OPAS, Optum, and enterprise goals.
• Build relationships across Optum, OPAS, OGA and clients.
• Collaborate with peers to ensure delivery of assignments.

Skills

45 wpm typing

HIPAA compliance

Strong communication

Self-motivation

Team collaboration

Education

Associate's degree

Tools

InterQual

MCG

Job description

UnitedHealth Group's Optum unit seeks a Utilization Management Nurse to review medical records and craft defensible appeal letters with attention to HIPAA and policy requirements. The role emphasizes timely, high-quality reviews of cases.

The position offers a 40-hour Monday–Friday schedule with telecommuting from anywhere in the U.S. and a competitive benefits package. Requires RN license, associate degree, and 3+ years bedside nursing in ED/ICU/telemetry.