DenverRecruiter Since 2001
the smart solution for Denver jobs

Pulmonary Medicine Physician General Pulmonologist - Physicians Only Apply - Perm

Company: UnitedHealth Group
Location: Denver
Posted on: July 1, 2020

Job Description:

A Pulmonary Medicine Physician General Pulmonologist practice is seeking a qualified physician for DENVER, CO. This and other physician jobs brought to you by ExactMD. Medical Doctors Only Apply.

Appeals and Grievances --- Work From Home
The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. Performance accountabilities include:
- 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 and the application of clinical criteria of medical policies.
- Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses. - Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations.
- Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues.
-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.

-MD or DO with an active, unrestricted license
-Board Certified in an ABMS or AOBMS specialty
-5+ years clinical practice experience
-Intermediate or higher level of proficiency with managed care
-2+ years Quality Management experience
- Excellent telephonic communication skills; excellent interpersonal communication skills.
- Excellent project management skills
- Data analysis and interpretation skills
- Excellent presentation skills for both clinical and non-clinical audiences; Familiarity with current medical issues and practices - Creative problem solving skills
- Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills; Internet researching skills
- Strong team player and team building skills.

Careers with UnitedHealthcare: Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Keywords: UnitedHealth Group, Denver , Pulmonary Medicine Physician General Pulmonologist - Physicians Only Apply - Perm, Healthcare , Denver, Colorado

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Healthcare Jobs

School Psychologist- Loveland, Colorado
Description: Soliant is looking to place a licensed School Psychologist in a great school district for the current school year The client
Company: Soliant Health
Location: Loveland
Posted on: 07/4/2020

Speech Language Pathologist Opening - CHEYENNE, WYOMING
Description: Soliant Health has partnered with an exceptional school district near the Cheyenne, WY area. We are actively scheduling interviews to fill a full time
Company: Soliant Health
Location: Cheyenne
Posted on: 07/4/2020

RN / Home Healthcare Nursing Job in Parker, Colorado
Description: Kindred at Home company is currently seeking caring and dependable people to work in the homes of our clients in Parker, CO. Overnight, Weekends and Evening shifts available. br br The combination (more...)
Company: Kindred at Home
Location: Parker
Posted on: 07/4/2020

School Based Speech Language Pathologist
Description: Sunbelt is currently looking to interview and hire a Speech Language Pathologist for a Full-Time
Company: Sunbelt Staffing
Location: Littleton
Posted on: 07/4/2020

Full-Time Speech Language Pathologist
Description: Sunbelt Staffing is hiring a Speech Language pathologist to work full-time in a school near Broomfield, CO. The
Company: Sunbelt Staffing
Location: Broomfield
Posted on: 07/4/2020

Certified Nursing Assistant - CNA
Description: HCR ManorCare provides a range of services, including skilled nursing care, assisted living, post-acute medical and rehabilitation care, hospice care, home health care and rehabilitation therapy. Certified (more...)
Company: HCR Manorcare Inc.
Location: Parker
Posted on: 07/4/2020

Speech Language Pathologist Job Opportunity
Description: We are currently interviewing for a schools-based Speech Language Pathologist SLP in the Broomfield, CO area. This is
Company: Sunbelt Staffing
Location: Broomfield
Posted on: 07/4/2020

Manager Clinical Nursing- Pre-Op, PACU, PAT, GI Lab
Description: Welcome to Centura Health br Welcome to the largest health ecosystem in Colorado and western Kansas. Welcome to living your mission among thousands of people on fire to live theirs too. Welcome to options, (more...)
Company: Centura Health
Location: Parker
Posted on: 07/4/2020

Massage Therapist
Description: Our Ken Caryl studio is proud to be recognized as having among the highest employee satisfaction of all Elements studios.Are you a Massage Therapist looking for a studio where you will be encouraged and (more...)
Company: Elements Massage
Location: Littleton
Posted on: 07/4/2020

Speech Language Pathologist (SLP)
Description: Full-Time Speech Language Pathologist SLP - Colorado br br Soliant is currently working with an exemplary school district near the Broomfield, CO area who is looking to fill a Speech Language
Company: Soliant Health
Location: Broomfield
Posted on: 07/4/2020

Log In or Create An Account

Get the latest Colorado jobs by following @recnetCO on Twitter!

Denver RSS job feeds