Senior Utilization Management RN – Remote-Eligible

UnitedHealth Group; Boston (MA); Hybrid; Confidential; Full time

Benefits offered by this job

Remote work possible

Benefits package

Job summary

UnitedHealth Group in Boston, MA is seeking a Sr Utilization Management Nurse to ensure accurate medical record coding, support proper payment to nursing facilities, and promote quality patient care. You will collaborate with peers and providers to discuss care details and review clinical information for appropriateness and outcomes.

The role requires 4+ years in long-term care or medical record review, an active MA RN license, RAC/CT MDS certification, and willingness to travel within

Qualifications

• Active MA RN license required.
• RAC/CT MDS certification required before start date.
• 4+ years nursing experience in long-term care/medical record review.

Responsibilities

• Audit medical records for accuracy of MDS coding to support facility payments.
• Audit anti-psychotic therapy for quality review.
• Discuss patient care details with peers/providers and present findings.

Skills

RN clinical experience

Travel readiness

Communication skills

HIPAA compliance

Education

Registered Nurse (RN) License MA

RAC/CT MDS certification

Tools

Microsoft Office Suite

Job description

UnitedHealth Group in Boston, MA is seeking a Sr Utilization Management Nurse to ensure accurate medical record coding, support proper payment to nursing facilities, and promote quality patient care. You will collaborate with peers and providers to discuss care details and review clinical information for appropriateness and outcomes.

The role requires 4+ years in long-term care or medical record review, an active MA RN license, RAC/CT MDS certification, and willingness to travel within