SSBV Clinical Claim Review RN

Optum, part of the United Health Group, is seeking a Clinical Claims Review RN (SSBV) to perform administrative reviews of short‑stay inpatient hospital claims and document determinations. The role supports a high‑volume, production‑driven environment and is eligible for telecommuting from anywhere in the U.S.

• Perform administrative reviews of short stay inpatient hospital claims in accordance with Federal, State and client specific requirements.
• Document all determinations and maintain accurate use of screening criteria.

Pay range: $28.94‑$51.83 per hour (full‑time). Additional benefits include: paid time off, paid holidays, medical, dental, vision, life & AD&D insurance, short‑term and long‑term disability, health spending or saving account, 401(k) savings plan, employee stock purchase plan, education reimbursement, employee assistance program, referral bonus, voluntary benefits, and other incentives subject to eligibility.

• Associate's degree.
• Current and unrestricted RN license in the state of residency.
• 5+ years of clinical documentation experience.
• 3+ years as an RN, including inpatient/acute setting.
• Intermediate proficiency in Microsoft Office (Excel, One Note).
• Intermediate writing proficiency.
• Designated home office workspace with secure high‑speed internet.

• Undergraduate or higher degree.
• Background in utilization review or case management.
• Familiarity with Inter Qual and/or MCG Care Guidelines.
• Critical thinking skills.

All Telecommuters must adhere to United Health Group’s Telecommuter Policy.

United Health Group is an Equal Employment Opportunity employer and will consider qualified applicants with arrest and conviction records. The company is a drug‑free workplace; candidates are required to pass a drug test before beginning employment.