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Job Details
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.