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Remote Optum Rn Jobs in Boca Raton, FL (NOW HIRING)

The Part-Time QA Nurse is a remote-based RN who plays a critical role in ensuring the clinical documentation integrity, regulatory compliance, and accreditation readiness of our Florida-based home ...

Anyone looking to begin a career in medicine (MD, DO, PA, NP, or RN) should consider becoming a medical scribe first! Scribe Pay Structure: $11/hour - No scribe experience $12/hour - 6+ months scribe ...

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Remote Optum Rn information

What is the difference between Remote Optum Rn vs Remote UnitedHealth Group Rn?

AspectRemote Optum RnRemote UnitedHealth Group Rn
CredentialsRegistered Nurse (RN) license, applicable certificationsRegistered Nurse (RN) license, applicable certifications
Work EnvironmentRemote healthcare services, telehealth platformsRemote healthcare services, telehealth platforms
Employer & IndustryOptum, healthcare and health services industryUnitedHealth Group, healthcare and insurance industry

Both Remote Optum Rn and Remote UnitedHealth Group Rn roles involve providing remote nursing care within the healthcare industry. They require similar credentials and work environments, often utilizing telehealth platforms. The main difference lies in the employer and specific focus areas within the healthcare sector, with Optum focusing on health services and UnitedHealth Group encompassing broader health insurance and services.

What are the most commonly searched types of Optum Rn jobs in Boca Raton, FL? The most popular types of Optum Rn jobs in Boca Raton, FL are:
What job categories do people searching Remote Optum Rn jobs in Boca Raton, FL look for? The top searched job categories for Remote Optum Rn jobs in Boca Raton, FL are:
What cities near Boca Raton, FL are hiring for Remote Optum Rn jobs? Cities near Boca Raton, FL with the most Remote Optum Rn job openings:

Utilization Review RN (Remote)

HealthPlus Staffing

Fort Lauderdale, FL • Remote

$80K - $100K/yr

Full-time

Posted 16 days ago


Job description

Quick Job Details:

Setting: Fully Remote – Utilization Review
Schedule: Full-Time, Monday–Friday
Hours: Standard business hours
Patient Volume: N/A
Job Requirements:

  • Active RN license with Multi-State/Compact license required
  • Minimum 2 years of Utilization Review experience
  • Minimum 3 years of clinical nursing experience (acute care/hospital preferred)
  • Strong understanding of medical necessity, utilization management, healthcare reimbursement, and clinical documentation improvement
  • Excellent communication, analytical, and critical thinking skills
  • Ability to work independently in a remote environment

Responsibilities:

  • Conduct admission, continued stay, and observation reviews
  • Apply medical necessity criteria to determine appropriate level of care
  • Review cases for Physician Advisor escalation when appropriate
  • Collaborate with physicians, case managers, and insurance payers
  • Support denial prevention, documentation improvement, and revenue cycle initiatives
  • Ensure compliance with payer guidelines and regulatory requirements
  • Analyze clinical and financial data to identify quality improvement opportunities

Compensation: Competitive; based on experience

Benefits: Comprehensive benefits package

About Us:

HealthPlus Staffing is a national leader in the healthcare staffing industry. We partner with top healthcare organizations nationwide to connect highly qualified professionals with outstanding career opportunities.

Our Promise:

  • We will put you in front of the decision makers.
  • We will provide feedback on your application.
  • We will work on your behalf to obtain as much information as possible to help you make a well-informed decision.

If you're interested in this opportunity, please submit an application or call 561-291-7787 to speak with one of our experienced consultants. We look forward to helping you find your next opportunity!

The HealthPlus Team