Support the creation and maintenance of medical policies that impact the quality of care for millions of people—all from home.
About UnitedHealthcare / UnitedHealth Group
At UnitedHealthcare, we’re simplifying the healthcare experience, building healthier communities, and removing barriers to quality care. As part of UnitedHealth Group, you’ll be backed by advanced technology, an inclusive culture, and opportunities for professional growth.
Schedule
- Full-time, Monday–Friday
- 100% remote within the United States
- May require occasional overtime based on business needs
What You’ll Do
- Research and maintain medical policies for Medicaid (Community and State)
- Collaborate on projects tied to value-creation initiatives
- Conduct clinical research as requested through the health technology support line
- Audit CPT, HCPCS, and ICD-10 coding for policy documents and benefits to ensure compliance
- Serve as a key resource on complex or critical issues
- Solve complex problems and propose innovative solutions
- Lead cross-functional discussions on clinical topics
- Present and explain findings to large group settings
What You Need
- Current Registered Nurse (RN) license
- 3+ years of experience in a managed care organization or health insurer
- Experience with Medicaid in Prior Authorizations, Appeals, Claims, or Medical Policy
- Familiarity with InterQual guidelines
Preferred Qualifications
- Certified medical coder (AAPC or AHIMA)
- 3+ additional years of Medicaid experience in authorizations, appeals, or policies
- Background in health technology assessment and evaluation
- Experience writing policies or SOPs
- Proficiency with MS Word and PowerPoint
- Strong critical thinking and attention to detail
- Excellent written and verbal communication skills, including presenting to large audiences
- Ability to work independently and manage multiple tasks in a high-volume environment
Benefits
- Competitive pay: $16.00 – $20.43 per hour (based on experience and location)
- Comprehensive benefits package including health, dental, vision, 401(k), and stock purchase plan
- Incentive and recognition programs
- Professional development and career growth opportunities
Join a team shaping medical policy to improve equity and care quality across the U.S.
Apply today and help transform the healthcare system.
Happy Hunting,
~Two Chicks…