Preservice Review Nurse RN - Remote

The Preservice Review Nurse RN will perform clinical coverage review services, interpreting state and federal mandates while working remotely. This role is ideal for nurses with strong clinical documentation skills and the ability to communicate effectively.

• Pay: $29 - $52/hour
• Location: Tulsa, OK
• Department/Unit: Remote
• Schedule: Full Time, Day shift
• Residency: Must reside in Oklahoma

• Perform clinical coverage review services, interpreting state and federal mandates and applicable benefit language.
• Function as a member of a self-directed team to meet specific individual and team performance metrics.
• Communicate in writing and verbally all types of benefit determinations, including decisions regarding coverage guidelines.
• Engage in telephonic discussions with healthcare providers and/or members to explain benefit coverage determinations and obtain additional clinical information.
• Act as a resource for others with less experience.
• Work independently while collaborating with Medical Directors and non-clinical partners.
• Adapt to a highly changing environment and manage a heavy case load.

Education: Bachelor's degree preferred

Experience:

• 2+ years of RN experience, including experience in an inpatient/acute setting
• Professional experience in direct patient care
• Background involving utilization review for an insurance company or experience in case management preferred

Licenses &

Certifications:

• Current unrestricted RN license in Oklahoma required
• Compact RN license preferred

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase and 401k contribution

United Health Group is a leading healthcare provider committed to delivering exceptional patient care. They harness technology and innovation to make healthcare simpler, more affordable, and more connected for the people they serve. The organization values diversity and inclusion, empowering employees to bring their authentic selves to work.