Role 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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. What makes your nursing career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within 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. For consideration you must be available to work Saturday and Sunday 8am until 5pm as well as three additional work weekdays 8am until 5pm and reside within the state of VA. If you are located in Virginia, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: - Authorization review and entry for HCBS authorizations using Virginia specific criteria - Review of state specific documents required for HCBS services - Communication with HCBS Providers - Gather clinical information to assess and expedite care needs - Consult with the Care Manager and/or Medical Director as needed to troubleshoot difficult or complex cases 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. Qualifications - Unrestricted, active RN license - 3+ years of RN experience in an acute setting - Utilization management, prior authorization, and case management experience - Managed care experience - Ability to create, edit, save and send documents utilizing Microsoft Word - Ability to navigate a Windows environment, Microsoft Outlook, and conduct Internet searches - Reside within Virginia Requirements - HCBS authorization experience - Working knowledge of ICUE and CAT Launchpad Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements) - Hourly pay for this role will range from $28.94 to $51.63 per hour based on full-time employment Company Description 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.

Role Description We’re unique. You should be, too. We’re changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team. Qualifications - Innovative and entrepreneurial minded - Strong work ethic and ambition - Ability to inspire others Requirements - Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. - This position may also be eligible for bonuses or commissions. Benefits - Great compensation - Comprehensive benefits - Career development and advancement opportunities - Great work-life balance - Opportunities to grow Company Description We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care. ChenMed is changing lives for the people we serve and the people we hire.

Role Description The Medical Data Reviewer (MDR), in close cooperation with the Medical Director (MD), sets up and coordinates the medical data review process, assists with medical data review and manages medical queries. The MDR role requires a close collaboration with various members of the Biometrics team, most frequently but not limited to the Data Coordinator & Lead Data Manager and Clinical Data Scientist. Specifically, the MDR reviews medical data for consistency and medical plausibility and ensures that the data is comprehensive from a medical point of view across different studies and projects. - Prepares listings with medical data (vital signs, lab data, medical history, concomitant medication, etc.) for medical review for plausibility and consistency. - Reviews and approves all test outputs of listings in collaboration with the MD and Biometrics team. - Plans and coordinates together with MD the medical review cycles and runs standard/customized listings as needed according to timeline. - Participates in or attends internal and client Kick-Off meetings, as needed. - Supports business development activities by providing input into feasibility activities related to medical data review. - Independently drafts the Medical Data Review Plan (MDRP) according to ICON standards, contract and client expectations (AWARD report / Proposal). - Independently coordinates project-specific tasks such as review of the electronic Case Report Form (eCRF) and CRF Completion Guidelines (CGS). - Raises and closes queries with minimal or w/o support of the Medical Director (MD). - Conducts medical review of the data as per MDRP on incremental listings and subject profiles in close collaboration with MD, using pre-established criteria to assure that the data is medically plausible and to clarify inconsistencies and missing Adverse Events (AE). - Reviews data for protocol deviations. - Coaches and mentors other medical team members, as needed. Qualifications - Registered Nurse or equivalent Health Care Professional or BSc in Biology and Scientific background. - Read, write and speak fluent English. - 3 years of relevant experience in clinical research. - Frequent use and general knowledge of industry practices, techniques, and standards. - Solves a variety of problems of moderate scope and complexity where analysis of situations or data requires a review of a variety of factors. Benefits - Competitive base salary and performance related incentives. - Health and wellbeing programmes including medical, dental, and vision coverage where applicable. - Retirement and pension plans. - Life assurance and disability coverage. - Employee assistance programmes and wellbeing resources. - Learning and development opportunities through structured training and career pathways. - Benefits may vary depending on role and location.

• Perform medical claim reviews for claims for medically complex services, services that require preauthorization/predetermination, requests for appeal or reconsideration, referrals for potential fraud and/or abuse, correct coding for claims/operations. • Make reasonable charge payment determinations based on clinical/medical information and established criteria/protocol sets or clinical guidelines. • Determine medical necessity and appropriateness and/or reasonableness and necessity for coverage and reimbursement. • Monitors process’s timeliness in accordance with contractor standards. • Document medical rationale to justify payment or denial of services and/or supplies. • Educate internal/external staff regarding medical reviews, medical terminology, coverage determinations, coding procedures, etc. in accordance with contractor guidelines. • Participate in quality control activities in support of the corporate and team-based objectives. • Provide guidance, direction, and input as needed to LPN team members. • Provides education to non-medical staff through discussions, team meetings, classroom participation, and feedback. • Assists with special projects and specialty duties/responsibilities as assigned by management.