Appeals MD - Plastic Surgeon Required - Remote
Company: UnitedHealthcare
Location: Scottsdale
Posted on: July 19, 2025
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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. Work at home! You’ll enjoy the flexibility to
work remotely * from anywhere within the U.S. as you take on some
tough challenges. 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 clinical practice experience 2 years 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 $238,000 to $357,500. 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. 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.
Keywords: UnitedHealthcare, Scottsdale , Appeals MD - Plastic Surgeon Required - Remote, Healthcare , Scottsdale, Arizona
