Utilization Management Nurse RN

About This Role The Utilization Management Nurse will accurately review and extract pertinent case details from patient medical records and craft defensible appeal letters. This role is ideal for those who thrive in a structured environment and are committed to high-quality patient care. Highlights Pay: $60,200 - $107,400/year Location: Newtown Square, PA Schedule: Full Time, Monday - Friday (40 Hours a Week), Flexible start times What You'll Do Compose appeal letters with appropriate data extraction and proper grammar Utilize appeal tools including pre-constructed templates and medical literature references Comply with HIPAA confidentiality requirements Support and promote OPAS, Optum, and enterprise goals Build relationships across Optum, OPAS, OGA, and clients Collaborate with peers to ensure continuity of communication Adhere to quality and productivity expectations Participate in and contribute to meetings as appropriate Maintain organization on the team and ensure professionalism Remain up to date with learning modules, competencies, and state required licenses Requirements Education: Associate's degree required Experience: 3+ years of bedside nursing experience in adult ED/telemetry/ICU/CCU Licenses & Certifications: Unrestricted Registered Nurse license in your state of residence required Advanced proficiency with Microsoft applications required Ability to type 45 wpm required Preferred Qualifications: Working knowledge of InterQual and MCG Prior experience with utilization management Strong verbal and written communication skills About UnitedHealth Group UnitedHealth Group is a leading healthcare provider committed to delivering exceptional patient care. They focus on improving health outcomes through innovative solutions and a culture of inclusion and collaboration. #J-18808-Ljbffr UnitedHealth Group