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Assistant Optum Clinical Review Jobs (NOW HIRING)

UnitedHealth Group

IBR Clinical Review RN

Plymouth, MN · On-site

Optum is a global organization that delivers care, aided by technology, to help millions of people ... The Clinical Review Clinician serves as a subject matter expert for itemized bill reviews and ...

UnitedHealth Group

IBR Clinical Review RN

Plymouth, MN · Remote

Optum is a global organization that delivers care, aided by technology, to help millions of people ... The Clinical Review Clinician serves as a subject matter expert for itemized bill reviews and ...

Natera

OR · On-site

Evaluate clinical documentation against coverage requirements. * Assist in identifying cases that may require additional clinical review or reimbursement support. * Stay current on evolving oncology ...

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Assistant Optum Clinical Review information

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How much do assistant optum clinical review jobs pay per hour?

As of Jun 16, 2026, the average hourly pay for assistant optum clinical review in the United States is $20.23, according to ZipRecruiter salary data. Most workers in this role earn between $16.59 and $23.32 per hour, depending on experience, location, and employer.

What is the difference between Assistant Optum Clinical Review vs Medical Reviewer?

AspectAssistant Optum Clinical ReviewMedical Reviewer
CredentialsTypically requires a healthcare-related degree or certification, such as RN or LPNRequires a medical degree (MD or DO) and medical license
Work EnvironmentHealthcare insurance companies, clinical review teams, administrative settingsHospitals, clinics, insurance companies, or private practices
Employer & Industry UsageCommonly employed by health insurance providers like Optum, focusing on utilization reviewUsed across healthcare settings for direct patient care and medical decision-making

The Assistant Optum Clinical Review role typically involves supporting clinical review processes within insurance companies, focusing on utilization management. In contrast, Medical Reviewers are licensed physicians or healthcare professionals who make clinical decisions and assessments directly related to patient care. While both roles require healthcare knowledge, Medical Reviewers have more advanced medical credentials and responsibilities.

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Assistant Optum Clinical Review jobs near you

Clinical Review Nurse

Turning Point Plans

Lake Mary, FL

Other

Posted 9 days ago

Job description

TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated individuals who want to be part of our mission and join our team!
As a Utilization Review Nurse, you will utilize your critical thinking skills, clinical expertise and judgement along with established medical criteria to perform first level clinical review for select procedures that require medical necessity authorization. We are seeking individuals who enjoy a challenge, have an ability to work independently and are capable of meeting deadlines. Previous utilization management experience is preferred. In addition to prior experience, the ideal candidate will have an extreme attention to detail, an ability to flourish in a fast-paced environment and advanced grammar, punctuation, and computer skills.
Responsibilities
  • Perform initial clinical reviews and provide documented recommendations based on the use of appropriate clinical guidelines
  • Review the initial evaluation and clinical documentation against clinical standards, applicable state regulations and relevant treatment guidelines
  • Assist clinical staff in quality improvement projects to provide instructive feedback to clients and providers within scope of practice
  • Resolve patient care issues by working one-on-one with community providers and staff to resolve issues in the determination process
  • Provide information by responding to queries of physicians and their practice staff, sorting and distributing messages and documents, and preparing information for determinations
  • Improve quality results by studying, evaluating procedures and processes and recommending changes, if needed
  • Serves and protects the company by adhering to accreditation standards, professional standards, company policies and procedures, federal, state, and local requirements, and professional and licensing standards
Qualifications:
  • Licensed Nurse Practitioner (LPN) or Registered Nurse (RN) required
  • Comprehensive knowledge of general nursing theory and practices
  • Excellent customer service skills and phone etiquette
  • Proficient computer skills, including typing and an ability to maneuver through various programs
  • Previous Utilization Management experience preferred but not required
  • Knowledge of musculoskeletal surgical procedures, cardiac procedures, pain management and/ or wound care is a plus
  • Ability to multi-task and manage tasks to completion on a timely basis and in an organized fashion
  • Ability to work collaboratively as part of a team

Salary:
RN- 62k-68k
LPN- 52k-58k

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