Remote Utilization Management RN - Appeals Specialist

Texas Health Institute; Northern (KY); Hybrid; USD 40,000 - 72,000; Full time

Benefits offered by this job

Comprehensive benefits package

401k contribution

Equity stock purchase

Job summary

Optum is seeking an Utilization Management Nurse to review patient records, extract essential details, and craft defensible appeal letters following process guidance. The role emphasizes HIPAA compliance and timely, high-quality reviews.

The position offers Per Diem scheduling with flexible start times and telecommuting from anywhere in the U.S. The hourly pay ranges from $29.00 to $52.00, based on experience and full-time status.

Qualifications

• Associate's degree required.
• Unrestricted RN license in your state of residence.
• 3+ years bedside nursing experience in ED/telemetry/ICU/CCU.
• Proficiency with Microsoft applications and software; strong typing (45 wpm).

Responsibilities

• Review and extract pertinent case details from patient records.
• Craft defensible appeal letters per process instructions.
• Adhere to HIPAA confidentiality requirements.
• Collaborate across Optum, OPAS, and clients to ensure deliverables.

Skills

Microsoft Office

Typing 45 wpm

Education

Associate's degree

Job description

Optum is seeking an Utilization Management Nurse to review patient records, extract essential details, and craft defensible appeal letters following process guidance. The role emphasizes HIPAA compliance and timely, high-quality reviews.

The position offers Per Diem scheduling with flexible start times and telecommuting from anywhere in the U.S. The hourly pay ranges from $29.00 to $52.00, based on experience and full-time status.