Appeals and Grievances Medical Director - Radiology Specialty Required - Remote
Cypress, CA
The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. Perform...

Bilingual (English / Spanish) Plan Advisor Representative - National Remote
Sharonville, OH
Provide an exceptional customer service experience when responding to and resolving customer service inquires and issues by identifying the topic and type of assistance the caller needs...

Inpatient Care Management Nurse RN - Indiana - Remote
Indianapolis, IN
Perform initial and concurrent review of inpatient cases applying evidenced based criteria (InterQual criteria) Discuss cases with facility healthcare professionals to obtain plans of ca...

Health Plan Clinical Operations Manager - DC Office Hybrid
Washington, DC
The UnitedHealthcare Community Plan of DC proudly serves the Dual Eligible Special Needs (D SNP) population in the District of Columbia and is excited to recruit for our leader of clinic...

Provider Network Access Specialist - Remote in New Mexico
Albuquerque, NM
Confirm contract compliance specifics to meet the needs Turquoise Care contract network standards Work with cross functional teams within UnitedHealthcare to strengthen provider networks...

Health Services RN - Remote in MN
St. Paul, MN
Serve as a Float care manager for members with varying needs on various teams Serve as documentation standards subject matter expert and assist with file preparations for audits Engage m...

Sr Actuarial Analyst - Remote
Minnetonka, MN
Modeling and forecasting plan performance for new clients Providing renewal & forecast support for existing clients Evaluating individual employer and book of business performance Assist...

Case Manager LTSS - Field Work in Mesa County, CO
Grand Junction, CO
Intake/screening/referral, assessment/reassessment, development of support plans, on going case management, monitoring of the Member's health and welfare, documentation of contacts and c...

Medical Director - Clinical Advocacy and Support - Remote
Nashville, TN
Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations Document clinical review findings,...

Behavioral Medical Director - Remote
Houston, TX
Ensuring delivery of cost effective quality care that incorporates recovery, resiliency and person centered services Responsible for Level of Care guidelines and utilization management p...

Nutritionist - Indianapolis, IN
Indianapolis, IN
Serves as a resource for UnitedHealthcare's care management and service coordination teams, including reviewing care plans for members who are on medically prescribed diets, receiving ga...

Senior Director of Actuarial Services - Remote (Minnetonka, MN preferred)
Minnetonka, MN
Lead an analytics team focused on supporting the portfolio of Utilization Management (UM) savings programs for the M&R business. Includes communicating findings and potential opportuniti...

HSS Coordinator-Nacogdoches, TX
Nacogdoches, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals f...

HSS Coordinator-Austin (Travis County), TX
Austin, TX
Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals f...

Actuarial Consultant - Remote
Minnetonka, MN
Developing and maintaining actuarial models Preparing experience analyses Preparing regulatory filings Assisting in the development of financial forecasts and projections Collaborating a...