Clinical Review Nurse (Rewards and advancement potential!)

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.



UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards.



We seek a talented RN who works well in a team environment to bring clinical expertise to this challenging role. While reviewing appeals cases, the chosen candidate would enjoy plenty of growth opportunities, a reliable M-F work schedule and flexibility in a structured environment.



Primary responsibilities include:


Reviewing appeals cases related to denials of coverage for medical charges


Assessing cases for appropriateness and quality of care


Collaborating with the Medical Director on a variety of case review efforts


Creating letters to document the outcomes for case decisions


Providing clinical support for coordinators

Job Requirements:

A current, active RN license in the state of CT is required. Clinical experience in an acute setting is also required. Managed care experience is preferred, along with a background in InterQual or Milliman & Robertson criteria. Coding experience is a plus. A BSN is preferred.



UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan. Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.