Per Diem Utilization Management Registered Nurse

UnitedHealth Group • Newtown Square, PA

2d • $29 - $52 • Remote

About The Position

The Utilization Management Nurse reviews and extracts pertinent details from patient medical records and prepares well-supported appeal letters according to process instructions and department and company guidance. The nurse completes cases within expected timeframes while maintaining high-quality reviews and following Optum and OPAS policies and procedures. This is a per diem, as-needed position with flexible start times. The role may be performed remotely from anywhere in the United States, subject to UnitedHealth Group’s Telecommuter Policy.

Requirements

• Associate’s degree.
• Unrestricted Registered Nurse license in the state of residence.
• At least 3 years of bedside nursing experience in ED, telemetry, ICU, or CCU.
• Advanced proficiency with Microsoft applications and software, internet navigation, and utilization.
• Ability to type 45 words per minute.
• Ability to establish priorities, be self-motivated, work independently, and follow instructions with supervision and structure.
• Positive attitude and ability to function as a collaborative team member.

Nice To Haves

• Working knowledge of Microsoft Word.
• Effective communication skills.
• Excellent typing skills, with a minimum speed of 45 words per minute.
• Solid verbal and written communication skills.

Responsibilities

• Extract appropriate data from medical records and compose clear, grammatically correct appeal letters using templates, medical literature references, and national criteria guidelines.
• Follow company and departmental policies, procedures, and applicable laws.
• Comply with HIPAA confidentiality requirements.
• Support and promote OPAS, Optum, and enterprise goals and mission.
• Build relationships across Optum, OPAS, OGA, and clients.
• Collaborate with peers to support continuity of communication and delivery of work.
• Meet quality and productivity expectations and complete cases within expected timeframes.
• Participate in and contribute to meetings as appropriate.
• Maintain team organization and professional conduct.
• Keep learning modules, competencies, and state-required licenses up to date.
• Perform other related duties, tasks, and processes as directed by leadership.
• Establish priorities, work independently, follow instructions, and contribute collaboratively as a team member.

Benefits

• Comprehensive benefits package, subject to eligibility requirements.
• Incentive and recognition programs, subject to eligibility requirements.
• Equity stock purchase, subject to eligibility requirements.
• 401(k) contribution, subject to eligibility requirements.

What This Job Offers

• Education Level: Associate degree