Medical Director
4 weeks ago
At UnitedHealthcare, we're simplifying the healthcare 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. We're looking for a talented Medical Director to lead our Appeals and Grievances team.
Key Responsibilities:- Perform individual case review for appeals and grievances for various health plan and insurance products, including PPO, ASO, HMO, MAPD, and PDP.
- Communicate with UnitedHealthcare medical directors regarding appeals decision rationales and benefit interpretations.
- Actively participate in team meetings focused on communication, feedback, problem-solving, process improvement, staff training, and evaluation.
- Provide clinical and strategic input when participating in organizational committees, projects, and task forces.
- MD or DO with an active, unrestricted license.
- PM and R Board Certified in an ABMS or AOBMS specialty.
- 5+ years clinical practice experience.
- 2+ years Quality Management experience.
- Intermediate or higher level of proficiency with managed care.
- Excellent telephonic communication skills, excellent interpersonal communication skills.
- Excellent project management skills.
- Data analysis and interpretation skills.
- Excellent presentation skills for both clinical and non-clinical audiences.
- Creative problem-solving skills.
- Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills.
- Internet researching skills.
- Solid team player and team building skills.
- A comprehensive benefits package.
- Incentive and recognition programs.
- Equity stock purchase.
- 401k contribution.
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.
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