JacksonvilleFLRecruiter
the smart solution for Jacksonville jobs

Administrative Physician - Physicians Only Apply - Perm

Company: UnitedHealth Group
Location: Jacksonville
Posted on: September 16, 2018

Job Description:

A Administrative Physician practice is seeking a qualified physician for JACKSONVILLE, FL. 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.

Qualifications:
-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, Jacksonville , Administrative Physician - Physicians Only Apply - Perm, Healthcare , Jacksonville, Florida

Click here to apply!

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


I'm looking for
in category
within


Other Healthcare Jobs


Gastroenterology in Florida
Description: VISTA represents a large private practice in northeastern Florida seeking a full-time General Gastroenterologist to join its team in 2017. Additional benefits include: Opportunity Benefits: Opportunity (more...)
Company: VISTA Staffing Solutions
Location: Port Orange
Posted on: 09/23/2018

Anesthesiologist (Ref #12808)
Description: An endo center in north central Florida has a need for a full-time anesthesiologist.
Company: Odyssey Staffing
Location: Jacksonville
Posted on: 09/23/2018

Psychiatry in FL - Permanent: Staff Psychiatrist Needed for 7 on/7 off Schedule in Jacksonville, FL
Description: Psychiatric-Mental Health opening in Jacksonville, Florida. This and other physician jobs brought to you by DocCafe.com CompHealth is currently assisting a Florida hospital with their search for a psychiatrist. (more...)
Company: CompHealth
Location: Jacksonville
Posted on: 09/23/2018


Physician / Surgery
Description: Join the National Center of Excellence for Wound Management Physician Group - Hiring
Company: Vohra Physicians
Location: Jacksonville
Posted on: 09/23/2018

DO / Physical Medicine and Rehab Job in Jacksonville, Florida / Permanent
Description: Seeking a Part Time pain /Physiatrist PMR-Physician for private
Company: HCRC Staffing
Location: Jacksonville
Posted on: 09/23/2018

Nurse - Medical Case Manager
Description: Excellence In Everything We TouchPosition SummaryThis is a work from home position requiring --local field case management travel. --To provide effective case management services in an appropriate, cost (more...)
Company: Crawford & Company
Location: Jacksonville
Posted on: 09/23/2018

Physicians / Nurse Practitioner Job in Port Orange, Florida
Description: Great opportunity to work with a fantastic company in the Daytona Beach area of Florida We are seeking a Full Time Urgent Care Physician Assistant or Nurse Practitioner to join our growing team Competitive
Company: K.A. Recruiting, Inc.
Location: Port Orange
Posted on: 09/23/2018

Medical Technologist I PRN
Description: North Florida Regional Medical Center NFRMC is a full-service medical and surgical acute care center serving 14 counties and offering comprehensive cardiovascular care, oncology, orthopedics, neurosciences, (more...)
Company: North Florida Regional Medical Center
Location: Gainesville
Posted on: 09/23/2018

Travel ICU/CCU Registered Nurse needed in GAINESVILLE
Description: Travel Registered Nurse ProLink Healthcare is selecting experienced RNs for contract opportunities in distinguished facilities throughout the country.-- We offer top-tier pay
Company: ProLink Staffing
Location: Gainesville
Posted on: 09/23/2018

Physician / Critical Care / Florida / Permanent / Intensivist Job
Description: North Florida Regional Medical Center, located in Gainesville, Florida, is just a short drive from the coast as well as many of Central Florida s premier attractions, like Disney. Gainesville
Company: HCA Physician Recruitment
Location: Gainesville
Posted on: 09/23/2018

Log In or Create An Account


Find us on Facebook

Find us on LinkedIn

Get the latest Florida jobs by following @recnetFL on Twitter!

Jacksonville RSS job feeds