Appeals Medical Director - OB GYN Required - MST or PST Preferred - Virtual
UnitedHealthcare
Scottsdale, AZ
14 hours ago
$238,000 - $357,500
Job Description
Join UnitedHealthcare as an Appeals Medical Director, where you'll play a crucial role in reviewing and adjudicating appeals and grievances, impacting the health care experience for millions. This remote position offers flexibility and opportunities for professional growth.
Key Responsibilities
Perform individual case review for appeals and grievances
Perform regulatory responses for Department of Insurance and CMS
Communicate with medical directors regarding appeals decision rationales
Participate in team meetings focused on communication and process improvement
Provide clinical and strategic input in organizational committees
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 Quality Management experience
Intermediate or higher level of proficiency with managed care
Proven excellent telephonic communication skills
Proven excellent project management skills
Proven data analysis and interpretation skills
Proven excellent presentation skills
Proven creative problem-solving skills
Proven basic computer skills
Benefits & Perks
Comprehensive benefits packageIncentive and recognition programsEquity stock purchase401k contribution