No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. You'll help improve the health of millions. And you'll do your life's best work.(sm) Reporting to the Assistant VP, the Associate Director, Clinical Appeals for Optum 360 will focus on overseeing all operational business facets related to the team writing clinical appeals. They will interface with other operational colleagues in strategizing and optimizing appeals management. They will daily engage the staff and ensure timely and quality appeals are written in response to of clinical denials received from commercial insurers by the Northwell Health system. Primary Responsibilities:Manages the operational activities of a business office consisting of 30 nurse appeal writersAssign cases to Clinical Appeals Nurse staff (30) for the production of written clinical appealsProvide clinical support for producing high quality, timely, and effectively written clinical appeals Evaluates performance and holds the team accountableInspires high performance and productionProvides leadership to and is accountable for the performance of the teamInterfaces with broad range of related entities associated with commercial insurance denials
Required Qualifications:4 year degree, Advanced degree preferredRN preferred3+ revenue cycle management experience4+ years of experience managing staff2+ years of direct hand-on experience with clinical appeals Proficient with Microsoft Word, Outlook, Excel, PowerPointCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: clinical support, appeals, operations, quality, revenue cycle, management, New York, NY
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.