Appeals Medical Director - OB GYN Required - MST or PST Preferred - Virtual
UnitedHealthcare
Tampa, FL
1 day ago
$238,000 - $357,500
Job Description
Join UnitedHealthcare as an Appeals Medical Director to impact the lives of millions by simplifying healthcare. Enjoy the flexibility of remote work while addressing complex clinical challenges.
Key Responsibilities
Perform individual case review for appeals and grievances
Perform regulatory responses to Department of Insurance/Department of Managed Healthcare, and CMS
Communicate with UnitedHealthcare medical directors regarding appeals decision rationales
Communicate with UnitedHealthcare Regional and Plan medical directors regarding access and quality issues
Participate in team meetings focused on communication and process improvement
Provide clinical and strategic input in organizational committees and projects
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 for both clinical and non-clinical audiences
Proven creative problem-solving skills
Proven basic computer skills
Benefits & Perks
Comprehensive benefits packageIncentive and recognition programsEquity stock purchase401k contribution