Remote Utilization Management Nurse RN:Appeals & Case Review

University of Minnesota School of Nursing; Northern (KY); Hybrid; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group is looking for an Utilization Management Nurse to review medical records, extract case details, and craft defensible appeal letters. The role emphasizes data extraction, template use, and adherence to HIPAA and company policies.

The position requires an Associate's degree, an unrestricted RN license, 3+ years in bedside nursing, and strong MS Office skills. It offers telecommuting from anywhere in the U.S. with a salary range of $60,200–$107,400 annually.

Qualifications

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

Responsibilities

• Compose appeal letters with data extraction and templates, ensuring proper grammar and references.
• Ensure HIPAA confidentiality and adherence to policies.
• Support OPAS, Optum, and enterprise goals.
• Build relationships with clients and cross-functional teams.
• Maintain high quality, organize meetings, and stay up to date with required licenses.

Skills

Registered Nurse

Typing 45 wpm

MS Office proficiency

Education

Associate's degree

Tools

InterQual

MCG

Microsoft Word

Job description

UnitedHealth Group is looking for an Utilization Management Nurse to review medical records, extract case details, and craft defensible appeal letters. The role emphasizes data extraction, template use, and adherence to HIPAA and company policies.

The position requires an Associate's degree, an unrestricted RN license, 3+ years in bedside nursing, and strong MS Office skills. It offers telecommuting from anywhere in the U.S. with a salary range of $60,200–$107,400 annually.