Talent.com
Clinical Consultant - Physician Associate - Remote
Clinical Consultant - Physician Associate - RemoteUnitedHealth Group • Minnetonka, MN, United States
Clinical Consultant - Physician Associate - Remote

Clinical Consultant - Physician Associate - Remote

UnitedHealth Group • Minnetonka, MN, United States
30+ days ago
Job type
  • Full-time
  • Remote
Job description

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

You'll enjoy the flexibility to work remotely

  • from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities :

  • In collaboration with and supervision by an Appeals and Grievances Medical Director, the Physician Associate 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 associates, and other members of the appeals staff
  • Perform individual case review 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
  • You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development.

    Required Qualifications :

  • Current Physician Assistant / Associate license in your state of residence
  • Current Board Certification by National Commission on Certification of Physician Assistants (NCCPA). (Physician Associate will maintain NCCPA certification for the length of employment)
  • 5+ years of clinical PA practice experience
  • Intermediate computer skills : MS Office, Outlook, Word, and Excel
  • Ability to work Monday-Friday normal business hours
  • Preferred Qualifications :

  • 1+ years of Utilization Management and Utilization Review processes
  • Experience with Appeals & Grievances
  • Experience with claims coding & review
  • Experience with project management
  • Experience with facilitating hospital admission process
  • Experience with participating in hospital inpatient admission process
  • Experience with conducting quality chart reviews
  • Inpatient PA experience
  • Knowledge of IPA, insurance, health plans and managed care functions
  • Proven ability to work well in a team environment
  • Leadership Priority Skills :

  • Use Resources
  • Get things done on time and on budget using available resources assigned for the tasks

  • Work with Others
  • Build and maintain productive relationships with coworkers using collaborative approaches

  • Execute
  • Understand the goals and tasks assigned, producing results by fulfilling and sometimes exceeding expectations

  • Support and Execute Change
  • Cooperate with and support change initiatives

  • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
  • Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all 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. Job posting may come down early due to volume of applicants.

    At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

    UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

    UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

    Create a job alert for this search

    Clinical Associate • Minnetonka, MN, United States

    Related jobs
    Associate Director, PDL Strategy - Remote

    Associate Director, PDL Strategy - Remote

    UnitedHealth Group • Minnetonka, MN, US
    Remote
    Full-time
    Associate Director, PDL Strategy.At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts...Show more
    Last updated: 30+ days ago • Promoted
    Edge Submissions Consultant - Remote

    Edge Submissions Consultant - Remote

    Optum • Eden Prairie, MN, US
    Remote
    Full-time
    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.The work you do with our team will directly improve health outcomes by connect...Show more
    Last updated: 3 days ago • Promoted
    Provider Credentialing Specialist (CPCS Required)

    Provider Credentialing Specialist (CPCS Required)

    Home Health Care, Inc. • Minneapolis, MN, us
    Full-time
    Quick Apply
    Monday – Friday from 8 : 00am to 5 : 00pm.Successful applicants will email Shawn at.Twin Cities Physicians (TCP) is a.With an emphasis on continuity of care, compassion, and. If you are organized, detai...Show more
    Last updated: 30+ days ago
    Travel Licensed Clinical Social Worker - $1858.7 / Week

    Travel Licensed Clinical Social Worker - $1858.7 / Week

    TotalMed Staffing • Waconia, MN, US
    Full-time
    TotalMed Staffing is seeking an experienced Licensed Clinical Social Worker for an exciting Travel Allied job in Waconia, MN. Shift : 5x8 hr days Start Date : 11 / 10 / 2025 Duration : 13 weeks Pay : $1858....Show more
    Last updated: 3 hours ago • Promoted • New!
    Physician Relations Consultant - Fellows

    Physician Relations Consultant - Fellows

    Medtronic Plc • Saint Paul, MN, US
    Full-time
    Join one of the most exciting growth opportunities in MedTech! Our CRDN portfolio includes Coronary PCI, Renal Denervation, and CathWorks FFRangio. Renal Denervation (RDN) is an innovative procedure...Show more
    Last updated: 30+ days ago • Promoted
    Clinical Solutions Consultant - Imaging or PACS - Remote

    Clinical Solutions Consultant - Imaging or PACS - Remote

    Optum • Minneapolis, MN, US
    Remote
    Full-time
    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.The work you do with our team will directly improve health outcomes by connect...Show more
    Last updated: 12 hours ago • Promoted • New!
    Senior Financial Consultant - Remote

    Senior Financial Consultant - Remote

    UnitedHealth Group • Circle Pines, MN, US
    Remote
    Full-time
    We are seeking a detail-oriented and strategic Sr Financial Consultant to oversee the development, maintenance, and compliance of our indirect rate structures and estimating system in alignment wit...Show more
    Last updated: 26 days ago • Promoted
    Physician Liaison

    Physician Liaison

    FYZICAL Therapy and Balance Centers • Edina, MN, US
    Full-time
    FYZICAL Therapy & Balance Centers is seeking a full-time Physician Liaison to join our team at our Edina, MN, location!.The Physician Liaison works closely with our clinical team and is a brand...Show more
    Last updated: 10 days ago • Promoted
    Clinical Automation and Integration Lead - Remote

    Clinical Automation and Integration Lead - Remote

    UnitedHealth Group • Circle Pines, MN, US
    Remote
    Full-time
    Clinical Implementation & Integration Lead.Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will ...Show more
    Last updated: 9 days ago • Promoted
    Licensed Professional Counselor (LPC) (No Associates) - Remote

    Licensed Professional Counselor (LPC) (No Associates) - Remote

    Rula Health • Minneapolis, MN, United States
    Remote
    Part-time
    Rula is a comprehensive behavioral health solution that works with a network of licensed clinicians to deliver high-quality care to individuals, couples, and families. By taking care of all the new ...Show more
    Last updated: 30+ days ago • Promoted
    Sr Director Clinical Consulting - Remote

    Sr Director Clinical Consulting - Remote

    UnitedHealth Group • Circle Pines, MN, US
    Remote
    Full-time
    Senior Director of Clinical Consulting.Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will dire...Show more
    Last updated: 30+ days ago • Promoted
    Senior Financial Consultant - Remote

    Senior Financial Consultant - Remote

    Optum • Eden Prairie, MN, US
    Remote
    Full-time
    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.We are seeking a deta...Show more
    Last updated: 3 days ago • Promoted
    Associate Director, PDL Strategy - Remote

    Associate Director, PDL Strategy - Remote

    UnitedHealthcare • Eden Prairie, MN, United States
    Full-time
    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people ...Show more
    Last updated: 12 days ago • Promoted
    Clinical Consultant - RN

    Clinical Consultant - RN

    PartnerRe • Maple Grove, MN, US
    Full-time
    PartnerRe is a leading, privately owned, multi-line global reinsurer with a reputation of financial stability and strength, and a commitment to rebuilding businesses and communities after risk even...Show more
    Last updated: 30+ days ago • Promoted
    Associate Director of Actuarial Services - Remote

    Associate Director of Actuarial Services - Remote

    UnitedHealthcare • Edina, Minnesota, United States
    Remote
    Full-time
    At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people ...Show more
    Last updated: 10 days ago • Promoted
    Associate Oral and Maxillofacial Surgeon

    Associate Oral and Maxillofacial Surgeon

    OMS Specialists • Saint Paul, US
    Full-time
    OMS Specialists is excited to announce a rare opportunity to join a thriving practice in the desirable Twin Cities area.As the oldest oral surgery practice in the Twin Cities, we have a large, esta...Show more
    Last updated: 30+ days ago • Promoted
    Senior Account Clinical Consultant Pharmacist - Remote

    Senior Account Clinical Consultant Pharmacist - Remote

    Optum • Minnetonka, MN, US
    Remote
    Full-time
    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.The work you do with our team will directly improve health outcomes by connect...Show more
    Last updated: 3 days ago • Promoted
    Family Medicine Physician

    Family Medicine Physician

    VillageMD • Monticello, US
    Full-time
    We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care. Our primary, multispecialty, and urgent care providers serve mil...Show more
    Last updated: 2 days ago • Promoted
    Dermatology Physician, Near the Twin Cities, Minnesota, Excellent Practice and Benefits

    Dermatology Physician, Near the Twin Cities, Minnesota, Excellent Practice and Benefits

    Curative • Lindstrom, US
    Full-time
    Dermatology Physician, Eastern Minnesota.Easy Access to the Minneapolis Airport and Sporting Events.Join a highly respected, multi-site dermatology group that values autonomy and clinical excellenc...Show more
    Last updated: 5 days ago • Promoted
    Licensed Professional Clinical Counselor (LPCC) (No Associates)

    Licensed Professional Clinical Counselor (LPCC) (No Associates)

    Rula Health • Bloomington, MN, United States
    Part-time
    Rula is a comprehensive behavioral health solution that works with a network of licensed clinicians to deliver high-quality care to individuals, couples, and families. By taking care of all the new ...Show more
    Last updated: 30+ days ago • Promoted