Preservice Review Nurse RN/Nurse Clinical Annotator - Remote in US

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Registered Nurse Clinical Annotator plays a critical role in supporting the development of artificial intelligence models designed to streamline and automate prior authorization processes in healthcare. This position leverages clinical expertise to interpret, annotate, and validate medical documentation, ensuring that AI systems are trained on accurate, contextually relevant, and policy-compliant data.

General Job Profile

Reviews the work of others
Develops innovative approaches
Sought out as expert
Serves as a leader/ mentor

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

Review medical records and interpret clinical documentation with accuracy and clinical judgment
Apply guideline based criteria to annotate, categorize, and label case data used for AI model training
Ensure annotations are clinically sound, consistent, and aligned with established utilization management (UM) guidelines
Contribute to the development of high quality training datasets that support safe and effective AI model performance
Identify gaps, ambiguities, or inconsistencies in documentation and escalate issues as needed
Participate in refinement and continuous improvement of annotation guidelines, clinical rules, and workflows
Collaborate with cross functional teams including data science, clinical operations, and product teams to ensure clinical accuracy and operational relevance of labeled data
Support testing, validation, and quality review activities for AI supported UM tools and workflows
Maintain detailed documentation of annotation decisions, rationales, and guideline interpretations
Uphold clinical, ethical, and regulatory standards in all aspects of data handling, patient information, and annotation workflows

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

Active, unrestricted RN license
3+ years of recent clinical experience in acute care, case management, utilization management, or a related clinical specialty
Solid understanding of clinical documentation, medical terminology, and evidence based practice
Experience applying guideline based criteria (e.g., InterQual, MCG) in clinical review or UM workflows
Ability to interpret medical records and determine clinical appropriateness using structured criteria
Proficiency with electronic medical records (EMR) and comfort navigating multiple clinical systems
Familiarity with HIPAA requirements, data privacy standards, and safe handling of patient information
Demonstrated experience performing clinical prior authorization reviews across diverse service categories, including medical/surgical procedures, diagnostic imaging, DME and related supplies, specialty therapies/devices, and other utilization management areas aligned to health plan medical policy
Ability to work independently while maintaining productivity, quality, and adherence to annotation guidelines
Curiosity and willingness to learn emerging technologies, AI supported workflows, and evolving guidelines

Preferred Qualifications

BSN
Experience collaborating with cross functional teams (clinical, data science, operations)
Experience with data labeling, clinical data annotation, or AI/ML workflows
High level of accuracy, attention to detail, and commitment to consistent, high quality annotations
Solid analytical thinking, clinical reasoning, and ability to identify gaps or inconsistencies in documentation
Effective written communication skills, with the ability to clearly document annotation decisions and rationales

Values Based Competencies Employee

Integrity Value: Act Ethically

Comply with Applicable Laws, Regulations and Policies
Demonstrate Integrity

Compassion Value: Focus on Customers

Identify and Exceed Customer Expectations
Improve the Customer Experience

Relationships Value: Act as a Team Player

Collaborate with Others
Demonstrate Diversity Awareness
Learn and Develop

Relationships Value: Communicate Effectively

Influence Others
Listen Actively
Speak and Write Clearly

Innovation Value: Support Change and Innovation

Contribute Innovative Ideas
Work Effectively in a Changing Environment

Performance Value: Make Fact-Based Decisions

Apply Business Knowledge
Use Sound Judgement

Performance Value: Deliver Quality Results

Drive for Results
Manage Time Effectively
Produce High-Quality Work
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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