Help us maintain the quality of our job listings. If you find any issues with this job post, please let us know.
Select the reason you're reporting this job:
When it comes to your health, everything matters. That’s why UnitedHealthcare is helping people live healthier lives and making the health system work better for everyone. Our health plans are there for you in moments big and small, delivering a simple experience, affordable coverage, and supportive care. Wherever your health takes you, we're there for what matters.
At UnitedHealthcare, part of the UnitedHealth Group family of businesses, we are working to create a system that is connected, aligned and more affordable for all involved; one that delivers high quality care, responsive to the needs of each person and the communities in which they live. With connections to more than 1.3 million physicians and care professionals and 6,500 hospitals and care facilities across the globe, we can collaborate in new ways to improve patient care while providing customizable and comprehensive solutions in any marketplace, anywhere.
Our Values
Integrity: Honor commitments. Never compromise ethics.
Compassion: Walk in the shoes of the people we serve and those with whom we work.
Relationships: Build trust through collaboration.
Innovation: Invent the future. Learn from the past.
Performance: Demonstrate excellence in everything we do.
For more information about UnitedHealthcare, click here: https://www.uhc.com/
For information about careers at UnitedHealthcare, click here: https://www.workatuhc.com
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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
You’ll enjoy the flexibility to work remotely - from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
Researching and maintaining medical policies for Community and State (Medicaid business)
Performing project work related to Value Creation projects
Perform clinical research as requested through a health technology support line
Auditing CPT, HCPCS and ICD-10 coding for medical policy documents and benefits for UHC ensuring we maintain compliance utilizing the appropriate coding for the review and reimbursement of medical services and benefits
Serve as a key resource on complex and/or critical issues
Solve complex problems and develop innovative solutions
Lead cross functional discussions related to clinical topics
Provide explanations and information to others on complex issues
Present work in large group settings
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.
Years of post-high school education can be substituted/is equivalent to years of experience.
Required Qualifications
Registered Nurse (RN)
3+ years of experience working within a managed care organization or health insurer
Experience working with the Medicaid line of business in Prior Authorizations, Appeals or Claims OR in Medical Policy
Experience with InterQual guidelines
Preferred Qualifications
Certified coder (AAPC or AHIMA)
3+ years of experience working with the Medicaid line of business in Prior Authorizations, Appeals or Claims OR in Medical Policy
Experience in health technology assessment and evaluation
Experience writing policies or SOPs
Proficient in the use of MS Word and PowerPoint
Proven critical thinking skills
Proven solid attention to detail
Proven excellent written and verbal communication skills including the ability to present information in or to large audiences
Proven ability to work with minimal supervision
Proven ability to multi-task, shifting back and forth effectively among multiple activities
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
The hourly range for this role is $16.00 to $20.43 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Required profile
Experience
Level of experience:Mid-level (2-5 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.