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Clinical Consultant - Physician Assistant - Remote

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UnitedHealthcare

Oct 12, 2024

Applications are closed

  • Job
    Full-time
    Senior Level
  • Research & Development
    Healthcare
  • Minnetonka
    Remote

Requirements

  • Current Physician Assistant/Associate license in your state of residence
  • Current Board Certification by National Commission on Certification of Physician Assistants (NCCPA). (Physician Associate will maintain NCCPA certification for the length of employment)
  • 5+ years of clinical PA practice experience
  • Intermediate computer skills: MS Office, Outlook, Word, and Excel
  • Ability to work Monday-Friday normal business hours.

Responsibilities

  • In collaboration with and supervision by an Appeals and Grievances Medical Director, the Physician Associate is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies
  • Work as part of an integrated team of medical director physicians, other physician associates, and other members of the appeals staff
  • 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, medical necessity, and the application of clinical criteria of medical policies)
  • 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, and the sharing of program results
  • Provide clinical and strategic input when participating in organizational committees, projects, and task forces

FAQs

Do we support remote work?

Yes, this position allows for remote work from anywhere within the U.S.

What qualifications are required for this position?

A current Physician Assistant/Associate license in your state of residence, current Board Certification by NCCPA, and 5+ years of clinical PA practice experience are required.

Is experience in Utilization Management necessary?

While it's preferred, having 1+ years of experience in Utilization Management and Utilization Review processes is not a strict requirement.

What are the working hours for this position?

The role requires availability for work during normal business hours, Monday to Friday.

What additional skills are preferred for applicants?

Preferred skills include experience with Appeals & Grievances, claims coding & review, project management, and conducting quality chart reviews, among others.

What is the salary range for this position?

The salary range for this role is between $88,000 to $173,200 annually, depending on factors such as location, education, and work experience.

Are there any benefits associated with this job?

Yes, UnitedHealth Group offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase options, and 401k contributions, among other benefits.

What is expected in terms of teamwork for this role?

The role requires building and maintaining productive relationships with coworkers using collaborative approaches, emphasizing teamwork in various integrated settings.

Will I have to adhere to any specific policies while working remotely?

Yes, all employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Does UnitedHealth Group have a commitment to diversity and inclusion?

Yes, UnitedHealth Group is committed to diversity and ensures equal employment opportunity for all qualified applicants, regardless of various characteristics protected by law.

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UnitedHealthcare

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

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.

Culture & 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.

Benefits

  • United Well-being

    United Well-being supports employees in their journey to better health. Resources include: Exercise and mindfulness apps. Tips and recipes for healthy cooking. Wellness coaching and financial tools. A private employee community group.

  • Health and Insurance

    Our medical plans for employees deliver better value and better outcomes. We offer: Copay plans and HSA-eligible plans. Vision and dental plans. Flexible spending accounts. Life insurance, and more.

  • Savings and Retirement

    In addition to competitive pay, we provide financial benefits to help employees manage their money. Benefits include: 401(k) Savings Plan. Employee Stock Purchase Plan. UnitedHealth Group credit union, and more.

  • Paid Time Off (PTO)

  • Paid Company Holidays

  • Parental Leave

  • Employee Assistance Program