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Remote RN: Utilization Management & Clinical Validation

Construction Association of Michigan

Brooklyn, NY
  • Remote job

Optum is seeking an Utilization Management & Clinical Validation RN to review medical records and extract key details for strong appeal letters. You will use ICD coding and evidence-based references to support decisions while adhering to HIPAA and policy guidelines. The role offers telecommuting flexibility within the U.S. and requires an RN license with 3+ years in ED/Telemetry/Critical Care, including 2+ years in clinical validation appeals. #J-18808-Ljbffr Construction Association of Michigan

Vacancy posted 3 days ago
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