Requisition Number: 2331837 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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Work at home! You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all 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. Primary Responsibilities: 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 What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. 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 for other roles you may be interested in. Required Qualifications: - MD or DO with an active, unrestricted license - Board Certified Cardiologist in an ABMS or AOBMS specialty - 5+ years of clinical practice experience - 2+ years of Quality Management experience - Familiarity with current medical issues and practices - Intermediate or higher level of proficiency with managed care - Proven excellent telephonic communication skills; excellent interpersonal communication skills - Proven excellent project management skills - Proven data analysis and interpretation skills - Proven excellent presentation skills for both clinical and non-clinical audiences. - Proven creative problem-solving skills - Proven basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills - Proven solid team player and team building skills *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $248,500.00 to $373,000.00. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. 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. 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.

Requisition Number: 2339495 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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Work at home! You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all 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. Primary Responsibilities: 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 What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. 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 for other roles you may be interested in. Required Qualifications: - MD or DO with an active, unrestricted license - Board Certified in an ABMS or AOBMS specialty - 5+ years of clinical practice experience - 2+ years of Quality Management experience - Intermediate or higher level of proficiency with managed care - Proven excellent telephonic communication skills; excellent interpersonal communication skills - Proven excellent project management skills - Proven data analysis and interpretation skills - Proven excellent presentation skills for both clinical and non-clinical audiences. Familiarity with current medical issues and practices - Proven creative problem-solving skills - Proven basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills - Proven solid team player and team building skills *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $248,500.00 to $373,000.00. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. 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. 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.

Requisition Number: 2312623 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. The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: 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 What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. 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 for other roles you may be interested in. Required Qualifications: - MD or DO with an active, unrestricted license - Board Certified in an ABMS or AOBMS specialty - No Pediatrics - 5+ years of clinical practice experience Preferred Qualifications: - 2+ years of Quality Management experience - Intermediate or higher level of proficiency with managed care - 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 - Solid team player and team building skills *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 $269,500 to $425,500 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.

• Collaborate, educate and oversee the delivery of patient care, clinical quality and compliance for an assigned group of bases. • Coordinate with clinical division leadership in the development, implementation and execution of new and existing standards, clinical quality management programs, educational and training standards and documentation. • Assist Clinical Director II with interface with AMS leadership as well as Regional leadership safety, risk and compliance teams, and clinical education team to ensure effective provision of medical care provided, including compliance with required AMC training, CAMTS and any state/county required standards. • Monitor and identify clinical care trends in area of responsibility (documentation and reported issues) for potential significant events or patterns; strategize Clinical Director II to share solutions. • Responsible for oversight and control of medical supply expenditures for assigned bases. • Assures efficient movement from third rider to second rider status; adjust clinical teammate assignments, schedule or training plan to assure efficiency. • Oversee the quality improvement program for assigned bases, clinical chart review, statistical analysis, multi-disciplinary dashboard; audits documentation, escalates potential issues and implements changes as directed to meet require standards. • Facilitate medical director involvement as needed within the chart review process; assist with communication to medical directors regarding, pertinent clinical concerns and issues and other topics as appropriate. • Participate in clinical investigation and remediation as indicated upon request by the Clinical Director II. • Provide input on annual performance appraisals for clinical teammates to Area Managers; provides input with performance management issues as appropriate. • Assist the Clinical Director II ensuring compliance to local, state, Commission of Air Medical Transport Systems (CAMTS) and Air Methods and applicable regulatory standards. • Assure bases are prepared for CAMTS accreditation/re-accreditation. • Escalate any issues as necessary to Clinical Director II. • Assist the Clinical Director II assuring all teammate clinical licenses/credentials are properly documented and current for billing and operations compliance. • Oversee, support, and mentor the clinical base lead in their responsibilities set forth within the clinical base lead job description.