Remote Utilization Management Nurse (RN)

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

Benefits offered by this job

Telecommuting

Job summary

Optum is a global health services company focused on improving health outcomes through innovative care and technology. The Utilization Management Nurse will review patient records and craft defensible appeal letters per guidelines while adhering to HIPAA and company policies.

The role offers a Monday–Friday schedule with 40 hours per week and telecommuting from anywhere in the U.S. The salary ranges from $60,200 to $107,400 annually, reflecting full-time employment and benefits.

Qualifications

• Associate's degree required.
• Unrestricted Registered Nurse license in your state of residence.
• 3+ years of bedside nursing experience in adult ED/telemetry/ICU/CCU.
• Advanced proficiency with Microsoft applications and software.
• Ability to type 45 wpm.

Responsibilities

• Follows directives to compose appeal letters with data extraction and references.
• Complies with HIPAA confidentiality requirements.
• Support and promote OPAS, Optum, and enterprise goals.
• Build relationships across Optum, OPAS, OGA and clients.
• Collaborate to ensure communication and delivery of results.
• Maintain high quality and productivity; participate in meetings.

Skills

Typing 45 wpm

Education

Associate's degree

Tools

Microsoft Office

Word

InterQual

MCG

Job description

Optum is a global health services company focused on improving health outcomes through innovative care and technology. The Utilization Management Nurse will review patient records and craft defensible appeal letters per guidelines while adhering to HIPAA and company policies.

The role offers a Monday–Friday schedule with 40 hours per week and telecommuting from anywhere in the U.S. The salary ranges from $60,200 to $107,400 annually, reflecting full-time employment and benefits.