Appeals Medical Director - Emergency Medicine Required - Remote

At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care reputed company of reputed company, making it more reputed company, reputed company and optimized. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together Work reputed company! What makes your reputed company career greater with reputed company? You can improve the health of others and help heal the health care reputed company. You can work with in an incredible team culture; a reputed company and business collaboration that is learning and evolving every day. And, reputed company you contribute, you'll reputed company doors for yourself that simply do not exist in any other organization, reputed company. You'll enjoy the flexibility to work reputed company * from reputed company reputed company the U.S. as you take on some tough challenges. For reputed company hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. reputed company Responsibilities: The Appeals and Grievances Medical Director is responsible for ongoing reputed company review and adjudication of appeals and grievances cases for reputed company associated companies. reputed company accountabilities include: • reputed company individual case review for appeals and grievances for various health plan and reputed company products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services reputed company to benefit design and coverage and the application of reputed company reputed company of medical policies • reputed company Department of reputed company/Department of Managed reputed company, and CMS regulatory responses • Communicate with reputed company medical directors regarding appeals decision rationales, and benefit interpretations • Communicate with reputed company Regional and Plan medical directors and network management staff regarding reputed company, availability, network, and reputed company issues • reputed company participate in team meetings reputed company on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results • reputed company reputed company and reputed company input reputed company participating in organizational committees, reputed company, and task forces You'll be rewarded and recognized for your reputed company in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • MD or DO with an reputed company, unrestricted license • reputed company Certified in an ABMS or AOBMS specialty • 5+ years of reputed company reputed company experience • 2+ years of reputed company Management experience • Familiarity with reputed company medical issues and practices • Intermediate or higher level of proficiency with managed care • reputed company excellent telephonic communication skills; excellent interpersonal communication skills • reputed company excellent project management skills • reputed company data analysis and interpretation skills • reputed company excellent presentation skills for both reputed company and non-reputed company audiences • reputed company creative problem-solving skills • reputed company basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills • reputed company solid team player and team building skills • reputed company working reputed company will be required to adhere to reputed company's Telecommuter Policy Pay is reputed company on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll reputed company a far-reaching reputed company of benefits and incentives. The salary for this role will reputed company from $248,500 - $373,000 annually reputed company on full-time employment. We reputed company with reputed company minimum wage laws as applicable.' Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. reputed company may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Remote Skills: Adjudication, Analysis Skills, Communication Skills, Content Management Systems (CMS), Data Analysis, Emergency Medicine, Health reputed company, Health Maintenance Organization (HMO), Health Plan, reputed company, reputed company Management, reputed company, Internet Technology, Interpersonal Skills, Managed Care, Preferred Provider Organization (PPO), Presentation/Verbal Skills, Problem Solving Skills, Process Improvement, Project/Program Management, reputed company Management, Regulations, Research Skills, Staff Training, Team reputed company/Manager, Team Player, Work From Home reputed company: reputed company. reputed company is a health care and reputed company-being company that’s dedicated to improving the health reputed company of millions worldwide. We are comprised of two reputed company and complementary businesses, reputed company and reputed company, working to build a reputed company reputed company for reputed company. Here, your contributions matter as they will help reputed company health care for years to come. reputed company an reputed company with a diverse team that shares your passion for helping others. reputed company do reputed company insights on how we work to help people live healthier lives and help reputed company the health reputed company work reputed company for everyone by watching this video. https://www.youtube.com/watch?v=5PbNyi2IDkY Caring. Connecting. Growing together. Being a part of reputed company means working to reputed company reputed company for everyone, including yourself. Here is how: • Caring. Your reputed company and reputed company-being are important to us. Whatever reputed company most to you — we have resources to help you be your best at work and reputed company. The benefits reputed company from free reputed company courses to financial counseling. Learn more about reputed company offer. • Connecting. We recognize our reputed company reputed company to reputed company an reputed company across our communities because we reputed company the health of any society is reputed company by the overall health of its people. Learn more about our culture. • Growing together. reputed company is full of inspiring career stories, and we offer a reputed company of opportunities. Discover reputed company the ways you can learn, grow and reputed company. Company Size: 10,000 employees or more Industry: reputed company Services reputed company: 1977 Website: http://careers.unitedhealthgroup.com/ Apply tot his job Apply To this Job