To begin the application process, please enter your email address.
Company Contact Info
- Portland, OR
Sorry, we cannot save or unsave this job right now.
Report this Job
Saving Your Job Alert
Job Alert Saved!
Could not save Job Alert!
You have too many Job Alerts!
This email address has reached the maximum of 5 email alerts. To create a new alert, you will need to log into your email and unsubscribe from at least one.
Email Send Failed!
Physician Assistant, Appeals & Grievances - Work from Home
UnitedHealth Group • Portland, OR
Posted 13 days ago
Get facts about other applicants with a CareerBuilder Account
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
As a part of our continued growth, we are searching for a new Physician Assistant to join our team.
This is a work from home opportunity!
- In collaboration with the Appeals and Grievances Medical Director, the Physician Assistant 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 Assistants, and other members of the appeals staff
- Performs individual case reviews 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
- Current Physician Assistant license in your state of residence
- Current Board Certification by National Commission on Certification of Physician Assistants (NCCPA)
- 3+ years clinical PA practice experience
- The ability to work well in a team environment
- Intermediate computer skills: MS Office, Outlook, Word and Excel
- 1+ years of Inpatient PA experience
- 1+ years of Utilization Management and Utilization Review processes
- Knowledge of IPA, insurance, health plans and managed care functions
- Experience with claims coding & review
- Experience in project management
Diversity creates a healthier atmosphere: 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.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Physician Assistant, PA, Managed care, UM, UR, Utilization Management, appeals & grievances, telecommute, work from home, telecommuting, telecommuter