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Job Title: Clinical Appeals Manager - RN or mental health professional
Job Location: PA: Philadelphia
Pay Rate: Open
Job Length: full time
Start Date: 2008-02-23
Company Name: UnitedHealth Group
Contact: Recruiter
Phone: email only please
Fax: email only please
Description: Clinical Appeals Manager - RN or mental health professional – 198565
Job Description
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Description OptumHealth Behavioral Solutions is driven by powerful and propriety clinical management methods that optimize the health and well-being of individuals. All Behavioral Solutions programs incorporate state-of-the-art predictive modeling, outcomes management and evidence-based best practices. The result is better care and a reduction in overall health care costs. We’re looking for an RN or licensed mental health professional to join our Philadelphia team. The Clinical Appeals Manager will oversee the Appeals department and coach and mentor the team. This is an excellent opportunity to bring your leadership skills and managed care background to a Fortune 50 company where you would enjoy great hours and nice perks such as an onsite fitness center. Take your career in a new direction, and apply today. Key responsibilities of the Clinical Appeals Manager include: * Managing the Appeals department * Handling employee relations * Coaching, mentoring and providing feedback to the team * Conducting performance evaluations * Facilitating team meetings * Monitoring team performance and managing workflow * Reviewing medical charts to assess authorization * Acting as the Subject Matter Expert for the department * Providing denials and appeals data to the quality improvement team * Making suggestions for quality improvement initiatives
Qualifications Requirements include: * Licensure as an RN or other licensed mental health professional (psychologist, LCSW, LPC) * Experience managing others * A background in managed care * Appeals processing experience * Proficiency in Microsoft Office applications * A Bachelor’s degree in nursing or a Master’s degree in the mental health field UnitedHealth Group offers a full range of comprehensive benefits to full-time and part-time employees, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan. Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V. Keywords: psychology, mental health, licensed mental health professional, social work, lcsw, psych rn, registered nurse, nurse, nursing jobs in Philadelphia, managed care, care management, lpc, psychologist, appeals, insurance, health insurance, medical insurance
Profile Job Field Mental Health Practitioners Locations US-PA-Philadelphia Organization United Behavioral Health Schedule Full-time
Please refer to Job code edhealthgroup-988011 when responding to this ad.
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