Remote Utilization Management RN: Appeals & Care Navigator

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

Benefits offered by this job

Benefits package

401k contribution

Equity stock purchase

Job summary

UnitedHealth Group is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters. The role supports telecommuting from anywhere in the United States and requires an RN license, an associate degree, and 3+ years bedside experience in adult ED/telemetry/ICU/CCU.

Responsibilities include data extraction, HIPAA compliance, and adherence to policies while delivering high-quality reviews.

Qualifications

• Must have HIPAA confidentiality knowledge and strict data handling.
• Strong written and verbal communication skills for patient interactions.
• Proficient typing at 45 wpm for fast data entry.

Responsibilities

• Compose appeal letters with data extraction and reference medical literature.
• Adhere to HIPAA, policies and procedures, and legal requirements.
• Promote OPAS, Optum, and enterprise goals in daily tasks.
• Build relationships across Optum, OPAS, OGA, and clients.
• Maintain productivity and participate in meetings as needed.

Skills

HIPAA compliance

Excellent communication

Typing 45 wpm

Education

Associate's degree

Tools

Microsoft Office

Job description

UnitedHealth Group is seeking an Utilization Management Nurse to review patient records and craft defensible appeal letters. The role supports telecommuting from anywhere in the United States and requires an RN license, an associate degree, and 3+ years bedside experience in adult ED/telemetry/ICU/CCU.

Responsibilities include data extraction, HIPAA compliance, and adherence to policies while delivering high-quality reviews.