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Clinical Appeals Nurse, RN - Home Infusion - Lenexa, KS

UnitedHealth Group

Lenexa, KS
Job Code:
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Job Details

Clinical Appeals Nurse, RN - Home Infusion - Lenexa, KS(Job Number:723072)

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. If you want to achieve more in your mission of healthcare, you have to be really smart about the business of healthcare. Challenge yourself, your peers, and our industry by shaping what healthcare looks like and doing your life's best work.(sm)

UnitedHealth Group is seeking talented individuals for our Home Infusion Clinical Appeals Nurse opportunities. You will be able to use your talents and experience to analyze proposed treatment protocols to ensure their appropriateness and responsiveness to patient needs and to provide clinical support for writing appeals for patients requiring complex infusible medications.  Our elite team of Clinical Appeals Nurses is growing and we want YOU to join this dynamic and exciting group.


We are now BriovaRx Infusion Services, and we recently joined Optum, part of the UnitedHealth Group family of companies.


Benefits include:

  • Competitive compensation
  • 100% office based, Monday through Friday schedule
  • The satisfaction that comes with knowing your effort allows patients to receive the care they need!
  • The opportunity to influence change with medical policies and coverage criteria

The Home Infusion Clinical Appeals Nurse fills an integral role in the clinical and intake operations of the organization, working collaboratively with a multi-disciplinary team to ensure infusion therapy can be safely and effectively administered to each home-based patient.


Primary Responsibilities:

  • Document patient demographic data, synopsis of care history, and compose letters or e - mails to payers with proposed treatment plan in accordance with health plan requirements
  • Develop a consultant relationship with assigned physicians / clinics / patients to build and sustain a patient - focused approached to care
  • Facilitate resolution of treatment requests for assigned patients
  • Advocates patient viewpoints to payers on decisions directly affecting coverage - related concerns
  • Participate on committees, work groups, and / or process improvement teams that improve patient outcomes and satisfaction

Job Clinical Appeals
Primary Location US-KS-Lenexa
Other Location 
Organization OptumRx AxelaCare
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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