22 days old

Clinical Consultant Durable Medical Equipment (DMEPOS) - Telecommute

Fort Lauderdale, FL 33301
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In collaboration with and supervision by a Medical Director, the DMEPOS Consultant provides support to Prior Authorization operations, the organization responsible for the initial clinical review of service requests for OptumCare. The DMEPOS Consultant  collaborates with OptumCare leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage and medical necessity determinations. The DMEPOS Consultant's daily activities primarily focus on the application of clinical knowledge in various utilization management activities regarding DMEPOS reviews with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package). 

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:
  • Work as part of an integrated team of medical director physicians, physician assistants, nurses, and other members of the OptumCare and Care Delivery staff
  • 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
  • Under the oversight of an OptumCare medical director, conduct coverage review based on individual member plan documents, and national and proprietary coverage review guidelines
  • Use clinical knowledge in the application and interpretation of medical policies and benefit document language in the process of prior authorization reviews for OptumCare and Care Delivery Organizations. Conduct daily clinical review and evaluation of all service requests collaboratively with Prior Authorization staff
  • Is available and accessible to OptumCare and Care Delivery Staff staff throughout the day to respond to inquiries. Serve as a clinical resource within OptumCare
  • Actively participate as a member of OptumCare and Care Delivery Organization teams in regular meetings and projects focused on communication, feedback, problem solving, process improvement, staff training and evaluation and sharing of program results
  • Actively participate in identifying and resolving problems and collaborates in process improvements that may be outside own team.

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.

Posted: 2020-03-13 Expires: 2020-04-25

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Clinical Consultant Durable Medical Equipment (DMEPOS) - Telecommute

UnitedHealth Group
Fort Lauderdale, FL 33301

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