Remote Utilization Management RN – Appeals & Case Review

UnitedHealth Group; Newtown Square (Delaware County); Remote; Confidential; Full time

Benefits offered by this job

Telecommuting allowed

Benefits package

Job summary

UnitedHealth Group seeks a Utilization Management Nurse to review medical records, extract data, and craft defensible appeal letters per policy. Per diem schedule with flexible start times, remote work across the U.S. emphasizes HIPAA and adherence to company policies.

Role requires an Associate's degree, an active RN license, 3+ years in ED/telemetry/ICU/CCU, and strong MS Office skills, plus typing 45 wpm. Perks include a comprehensive benefits package and telecommuter policy adherence.

Qualifications

• Unrestricted RN license in your state of residence.
• 3+ years bedside nursing experience in ED/telemetry/ICU/CCU.
• Proficiency with Microsoft applications and software; fast typist (45 wpm).

Responsibilities

• Compose appeal letters with data extraction and templates, ensuring proper grammar and references.
• Adhere to HIPAA confidentiality requirements.
• Support and promote OPAS, Optum, and enterprise goals.
• Build relationships across Optum, OPAS, OGA and clients.
• Collaborate with peers to ensure communication and deliverables.
• Meet quality and productivity expectations.
• Participate in meetings and maintain team organization.
• Stay current with required licenses and training.
• Perform related duties as directed by leadership.
• Prioritize work, work independently, and follow instructions.
• Maintain a positive, collaborative team mindset.

Skills

RN nursing

HIPAA compliance

Microsoft Office

Touch-typing 45 wpm

Education

Associate's degree

Tools

Microsoft Office

Job description

UnitedHealth Group seeks a Utilization Management Nurse to review medical records, extract data, and craft defensible appeal letters per policy. Per diem schedule with flexible start times, remote work across the U.S. emphasizes HIPAA and adherence to company policies.

Role requires an Associate's degree, an active RN license, 3+ years in ED/telemetry/ICU/CCU, and strong MS Office skills, plus typing 45 wpm. Perks include a comprehensive benefits package and telecommuter policy adherence.