Talent.com
Appeals M.D. - Gastroenterologist Required - Remote

Appeals M.D. - Gastroenterologist Required - Remote

UnitedHealth GroupCypress, CA, United States
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.filters.remote
job_description.job_card.job_description

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.

Work at home!

The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies.

You'll enjoy the flexibility to work remotely

  • from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities :

  • Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies
  • Perform Department of Insurance / Department of Managed Healthcare, and CMS regulatory responses
  • Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations
  • Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues
  • Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results
  • Provide clinical and strategic input when participating in organizational committees, projects, and task forces
  • What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.

    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 :

  • MD or DO with an active, unrestricted license
  • Board Certified in an ABMS or AOBMS specialty
  • 5+ years clinical practice experience
  • 2+ years of Quality Management experience
  • Intermediate or higher level of proficiency with managed care
  • Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills
  • Proven excellent telephonic communication skills; excellent interpersonal communication skills
  • Proven excellent project management skills
  • Proven data analysis and interpretation skills
  • Proven excellent presentation skills for both clinical and non-clinical audiences. Familiarity with current medical issues and practices
  • Proven creative problem-solving skills
  • Proven solid team player and team building skills
  • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
  • Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. 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.

    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.

    serp_jobs.job_alerts.create_a_job

    Gastroenterologist • Cypress, CA, United States

    Job_description.internal_linking.related_jobs
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Gastroenterologist - Southern California- Partnership Track

    Gastroenterologist - Southern California- Partnership Track

    AMN HealthcarePOMONA, CA, US
    serp_jobs.job_card.full_time
    Job Description & Requirements.Gastroenterologist - Southern California- Partnership Track.StartDate : ASAP Pay Rate : $650000. An established private gastroenterology practice in Southern California ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Gastroenterologist (St. Jude Heritage Medical Group)

    Gastroenterologist (St. Jude Heritage Medical Group)

    ProvidenceFullerton, US
    serp_jobs.job_card.full_time
    Jude Heritage medical group is actively seeking a board certified / board eligible Gastroenterologist to join our well-established team, providing a unique opportunity for professional growth.This ro...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Gastroenterologist - Per Diem I Optum CA

    Gastroenterologist - Per Diem I Optum CA

    OptumLong Beach, California, us
    serp_jobs.job_card.full_time
    Optum CA is seeking a Gastroenterologist - Per Diem.Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Locum General Surgeons – Nationwide Opportunities

    Locum General Surgeons – Nationwide Opportunities

    Jobot HealthLos Angeles, US
    serp_jobs.job_card.full_time
    Hassle-free licensing and credentialing - let’s find your next locums role!.We’re partnering with hospitals and surgical centers nationwide to connect experienced General Surgeons with ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    BC / BE - General Otolaryngology Head and Neck Surgeon

    BC / BE - General Otolaryngology Head and Neck Surgeon

    Head & Neck Associates of Orange CountyOrange, US
    serp_jobs.job_card.full_time +1
    JOIN OUR SUCCESSFUL ENT PRACTICE IN ORANGE COUNTY CALIFORNIA.We are a Fifteen physician practice looking for a BC / BE General Otolaryngologist comfortable treating both pediatric and adult patients....serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Gynecologic Oncologist

    Gynecologic Oncologist

    MemorialCare Medical FoundationLong Beach, CA, US
    serp_jobs.job_card.full_time
    Base Salary Range • : $475,000 to $510,000 .The salary range above is an estimated annual base salary for a full-time position. Your Total Rewards would include a base salary plus performance-based i...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Gastroenterology Physician Locum Tenens Job in California

    Gastroenterology Physician Locum Tenens Job in California

    All Star Healthcare SolutionsLos Angeles, CA, US
    serp_jobs.job_card.full_time
    All Star is seeking a gastroenterologist for long‐term locum tenens coverage in southern California.This opportunity involves performing scopes at surgical centers with consistent weekly scheduling...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Gastroenterologist – University of Southern California (USC), Henry Mayo Newhall Hospital

    Gastroenterologist – University of Southern California (USC), Henry Mayo Newhall Hospital

    USC Keck School of MedicineLos Angeles, US
    serp_jobs.job_card.full_time
    The Henry Mayo Newhall Hospital, in conjunction with the Keck School of Medicine of USC, a world-renowned academic medical center in Los Angeles, is seeking a General Gastroenterologist to join our...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Gastroenterology

    Gastroenterology

    VISTA Staffing SolutionsTorrance, CA, US
    serp_jobs.job_card.full_time +1
    Are you a gastroenterology physician searching for your next exciting locum tenens opportunity? This position with one of VISTA's healthcare partners in sunny California might just be the opportuni...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Gastroenterologist in beautiful Arcadia, CA - 13 miles to Los Angeles

    Gastroenterologist in beautiful Arcadia, CA - 13 miles to Los Angeles

    AMSURGArcadia, CA, US
    serp_jobs.job_card.full_time
    We are looking for a gastroenterologist to join our busy practice.We are currently a group of 6, with a large volume for you to be busy immediately!. Two office locations and One ASC .Competitive sa...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Gastroenterologist - Long Beach, CA

    Gastroenterologist - Long Beach, CA

    OptumLong Beach, California, us
    serp_jobs.job_card.full_time
    Optum CA is seeking a Gastroenterologist to join our team in Long Beach, CA.Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Car...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    • serp_jobs.job_card.new
    Pediatric Hematology Oncologist Is Wanted for Locums Assistance in California

    Pediatric Hematology Oncologist Is Wanted for Locums Assistance in California

    CompHealthOrange, CA, US
    serp_jobs.job_card.permanent
    When it comes to finding the perfect locums assignment, sometimes it's all about who you know.CompHealth has been around for a long time and have a vast network of connections to facilities across ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
    • serp_jobs.job_card.promoted
    Gastroenterologist (Providence Medical Associates)

    Gastroenterologist (Providence Medical Associates)

    ProvidenceTorrance, US
    serp_jobs.job_card.full_time
    Providence Medical Associates is seeking a full-time board-certified / board-eligible Gastroenterologist to join its expanding practice in Torrance, California. As part of our team, you will experienc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Gastroenterologist Opportunity with Kaiser Permanente in Southern CA

    Gastroenterologist Opportunity with Kaiser Permanente in Southern CA

    Kaiser Permanente – Southern California Permanente Medical GroupLos Angeles, US
    serp_jobs.job_card.full_time +1
    Salary range for full-time / part-time openings is $510,775.Potential premium earnings are up to $56,160.Salaries are inclusive of incentives depending on skills and competencies and geographic locat...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Gastroenterologist Sign-On Bonus, Specialist Incentive, Work / Life Balance - Optum CA

    Gastroenterologist Sign-On Bonus, Specialist Incentive, Work / Life Balance - Optum CA

    OptumLong Beach, US
    serp_jobs.job_card.full_time
    Optum CA is seeking a Gastroenterologist to join our team in Long Beach, CA.Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Car...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Gastroenterologist

    Gastroenterologist

    GI AllianceCypress, US
    serp_jobs.job_card.full_time
    Discover the advantages of Advanced Independent Practice - .Texas Digestive Disease Consultants (TDDC) - Cypress Gastrointestinal Disease Center. As a member of GI Alliance (GIA), .GI Alliance’s rob...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Physician | Gastroenterologist

    Physician | Gastroenterologist

    City of HopeIrvine, US
    serp_jobs.job_card.full_time
    Physician | Gastroenterologist | Irvine, CA.City of Hope Orange County is redefining the boundaries of what’s possible in cancer research and treatment. We’re bringing access to our scientific exp...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Physician / Gastroenterology / California / Permanent / Gastroenterologist Opportunity in Los Angele

    Physician / Gastroenterology / California / Permanent / Gastroenterologist Opportunity in Los Angele

    Pacific Companies, Inc.Los Angeles, CA, US
    serp_jobs.job_card.permanent
    Pacific Companies is excited to present an exceptional opportunity for a Gastroenterologist to join a thriving practice in downtown Los Angeles. This position offers the perfect balance of working i...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30