Telecommute Utilization Management RN — Appeals Specialist

ISHE; Northern (KY); Hybrid; USD 40,000 - 72,000; Full time

Benefits offered by this job

Telecommuting

Job summary

Optum is seeking a Utilization Management Nurse to review patient records and craft appeal letters. This per diem role offers flexible start times and the option to telecommute from anywhere in the U.S.

You will adhere to HIPAA, contribute to OPAS policies, and support enterprise goals, while maintaining high-quality reviews and timely delivery. The role requires an associate degree, RN license, and 3+ years bedside nursing experience in ED/telemetry/ICU/CCU, with strong MS Office skills and a

Qualifications

• Associate's degree required.
• Unrestricted Registered Nurse License in your state of residence.
• 3+ years of bedside nursing experience in ED/Telemetry/ICU/CCU.

Responsibilities

• Review patient medical records and extract pertinent case details.
• Craft defensible appeal letters per process instructions and guidelines.
• Maintain HIPAA confidentiality and comply with policies.
• Collaborate with teams to ensure accurate and timely deliverables.

Skills

RN license

Clinical nursing

MS Office

Typing speed 45 wpm

Education

Associate's degree

Tools

Microsoft Office

Word

Job description

Optum is seeking a Utilization Management Nurse to review patient records and craft appeal letters. This per diem role offers flexible start times and the option to telecommute from anywhere in the U.S.

You will adhere to HIPAA, contribute to OPAS policies, and support enterprise goals, while maintaining high-quality reviews and timely delivery. The role requires an associate degree, RN license, and 3+ years bedside nursing experience in ED/telemetry/ICU/CCU, with strong MS Office skills and a