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Remote RN: Utilization & Clinical Validation Specialist

$60.2k - $107.4k

Texas Health Institute

Brooklyn, NY
  • Remote job

Optum is a global organization that delivers care, aided by technology to help millions live healthier lives. The Utilization Management & Clinical Validation RN role involves reviewing medical records, extracting pertinent details, and crafting evidence-based appeal letters per guidelines. You will enjoy telecommuting from anywhere in the U.S. The salary range for this full-time position is $60,200 to $107,400 annually, with comprehensive benefits and opportunities for career development. #J-18808-Ljbffr Texas Health Institute

Vacancy posted 1 day ago
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