Remote Utilization Nurse RN — Appeals & Care

Rhode Island Bar Assn.; Northern (KY); Hybrid; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group seeks an Utilization Management Nurse to review patient records, craft defensible appeal letters, and ensure adherence to HIPAA and policy. Remote work within the U.S. supports flexible scheduling and collaboration with cross-functional teams.

The role requires an RN license, an Associate's degree, and 3+ years of bedside nursing experience in ED/ICU settings, with strong Microsoft Office skills and data extraction abilities.

Qualifications

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

Responsibilities

• Follows directive of composing appeal letters with data extraction and templated content.
• Complies with HIPAA confidentiality requirements.
• Support and promote OPAS, Optum, and enterprise goals.

Skills

RN license

Communication

Typing 45 wpm

Microsoft Office

Education

Associate's degree

Tools

Word

Microsoft Office

Job description

UnitedHealth Group seeks an Utilization Management Nurse to review patient records, craft defensible appeal letters, and ensure adherence to HIPAA and policy. Remote work within the U.S. supports flexible scheduling and collaboration with cross-functional teams.

The role requires an RN license, an Associate's degree, and 3+ years of bedside nursing experience in ED/ICU settings, with strong Microsoft Office skills and data extraction abilities.