Remote Utilization Management Nurse RN

Optum; United States; Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Telecommuting from anywhere in the U.S

Comprehensive benefits package

401k contribution

Equity stock purchase

Job summary

Optum is seeking an Utilization Management Nurse to review medical records, extract key case details, and craft defensible appeal letters in line with process instructions and guidelines.

The role requires an RN with an associate degree, 3+ years bedside nursing, HIPAA compliance, and proficiency with Microsoft tools. It offers a 40-hour week, telecommuting from anywhere in the U.S., and a competitive benefits package.

Qualifications

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

Responsibilities

• Reviews patient medical records and extracts pertinent case details for appeals.
• Crafts defensible appeal letters with data and literature references.
• Adheres to HIPAA and company policies and procedures.
• Builds relationships with OPAS, Optum, OGA and clients.
• Collaborates with peers to ensure communication and delivery of tasks.

Skills

Microsoft Office

Typing 45 wpm

HIPAA compliance

Verbal and written communication

Team collaboration

Education

Associate's degree

RN license

Tools

InterQual

MCG

Microsoft Word

Job description

Optum is seeking an Utilization Management Nurse to review medical records, extract key case details, and craft defensible appeal letters in line with process instructions and guidelines.

The role requires an RN with an associate degree, 3+ years bedside nursing, HIPAA compliance, and proficiency with Microsoft tools. It offers a 40-hour week, telecommuting from anywhere in the U.S., and a competitive benefits package.