PortlandRecruiter Since 2001
the smart solution for Portland jobs

Pulmonary Medicine Physician General Pulmonologist - Physicians Only Apply - Perm

Company: UnitedHealth Group
Location: Portland
Posted on: August 3, 2020

Job Description:

A Pulmonary Medicine Physician General Pulmonologist practice is seeking a qualified physician for PORTLAND, OR. This and other physician jobs brought to you by ExactMD. Medical Doctors Only Apply.

Appeals and Grievances --- Work From Home
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.

Qualifications:
-MD or DO with an active, unrestricted license
-Board Certified in an ABMS or AOBMS specialty
-5+ years clinical practice experience
-Intermediate or higher level of proficiency with managed care
-2+ years Quality Management experience
- Excellent telephonic communication skills; excellent interpersonal communication skills.
- Excellent project management skills
- Data analysis and interpretation skills
- Excellent presentation skills for both clinical and non-clinical audiences; Familiarity with current medical issues and practices - Creative problem solving skills
- Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills; Internet researching skills
- Strong team player and team building skills.

Careers with UnitedHealthcare: Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Keywords: UnitedHealth Group, Portland , Pulmonary Medicine Physician General Pulmonologist - Physicians Only Apply - Perm, Healthcare , Portland, Oregon

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Travel RN - Med/Surg - Nights - Clackamas , OR
Description: FlexCare is a nationwide leader in the staffing of travel nurses and clinicians. With access to thousands of facilities around the country, our mission is to deliver premier travel staffing solutions (more...)
Company: FlexCare Medical Staffing
Location: Clackamas
Posted on: 08/13/2020

Emergency Room Travel Nurse RN - $54/hour
Description: Nomad Health, the modern healthcare staffing company, seeks an experienced registered nurse for this rewarding travel assignment opportunity.Join
Company: Nomad Health
Location: Dundee
Posted on: 08/13/2020

Registered Nurse - RN - Emergency Room - ER
Description: Registered Nurse - RN - Emergency Room - ER CareerStaff Unlimited is looking to hire an RN Registered Nurse for full-time, 13 week contract opportunities in Portland, OR. This will be NOC shift, 36 hours (more...)
Company: CareerStaff Unlimited
Location: Portland
Posted on: 08/13/2020


Emergency Room Travel Nurse RN - $54/hour
Description: Nomad Health, the modern healthcare staffing company, seeks an experienced registered nurse for this rewarding travel assignment opportunity.Join
Company: Nomad Health
Location: Clackamas
Posted on: 08/13/2020

Registered Nurse - RN -Intensive Care Unit- ICU
Description: Registered Nurse - RN - Intensive Care Unit - ICU CareerStaff Unlimited is looking to hire a Registered Nurse for full-time, 11 week contract opportunities in Clackamas, OR. This will be NOC shift and (more...)
Company: CareerStaff Unlimited
Location: Portland
Posted on: 08/13/2020

MS Travel RN - Job Id: JO02897316
Description: Tailored Healthcare Staffing is seeking
Company: Tailored Healthcare Staffing
Location: Portland
Posted on: 08/13/2020

Medical Surgical Nurse - Travel - (MS RN)
Description: Job Description RequirementsMedical Surgical Nurse - MS RN StartDate: 08/25/2020Available Shifts: 12 D Pay Rate: 1321.00 - 1457.00This position presents an opportunity to join an elite team of passionate (more...)
Company: Onward HealthCare
Location: Portland
Posted on: 08/13/2020

Labor & Delivery Nurse - Travel - (LD RN)
Description: Job Description RequirementsLabor Delivery Nurse - LD RN StartDate: 09/04/2020Available Shifts: 12 D Pay Rate: 1462.00 - 1612.00Providence St. Vincent Medical Center is part of Providence Health (more...)
Company: American Mobile Healthcare
Location: Portland
Posted on: 08/13/2020

Travel RN - Endo - Days - Portland , OR
Description: FlexCare is a nationwide leader in the staffing of travel nurses and clinicians. With access to thousands of facilities around the country, our mission is to deliver premier travel staffing solutions (more...)
Company: FlexCare Medical Staffing
Location: Portland
Posted on: 08/13/2020

ER Travel RN - Job Id: JO02901806
Description: Tailored Healthcare Staffing is seeking
Company: Tailored Healthcare Staffing
Location: Portland
Posted on: 08/13/2020

Log In or Create An Account

Get the latest Oregon jobs by following @recnetOR on Twitter!

Portland RSS job feeds