Clinical Reviewer

Welcome to UnitedHealth Group, where we are passionate about helping people live healthier lives. We are currently seeking a highly motivated and experienced Clinical Reviewer to join our team. As a Clinical Reviewer, you will play a vital role in ensuring the quality and accuracy of medical records and clinical documentation. We are looking for someone with a strong clinical background and excellent attention to detail to support our mission of providing high-quality healthcare services. If you are a dedicated and compassionate individual with a passion for making a positive impact in the healthcare industry, we encourage you to apply for this exciting opportunity.

1. Review and analyze medical records and clinical documentation to ensure accuracy and completeness.
2. Conduct in-depth reviews of patient medical histories, treatments, and outcomes to identify any potential issues or discrepancies.
3. Collaborate with healthcare providers and other team members to gather additional information and clarify any discrepancies.
4. Utilize clinical knowledge and expertise to assess the quality of care provided and identify areas for improvement.
5. Maintain up-to-date knowledge of industry standards, regulations, and best practices related to medical record documentation and review.
6. Communicate findings and recommendations to healthcare providers and other team members in a clear and professional manner.
7. Identify and report any potential risk management issues related to clinical documentation.
8. Participate in training and education initiatives to improve the overall quality of clinical documentation.
9. Utilize technology and tools to ensure efficient and accurate review and documentation processes.
10. Maintain confidentiality and adhere to HIPAA regulations while handling sensitive medical information.
11. Serve as a resource and mentor to other team members, providing guidance and support as needed.
12. Contribute to the continuous improvement of processes and procedures related to clinical review.
13. Adhere to company policies and procedures, as well as all relevant laws and regulations.
14. Uphold the company's mission and values of providing high-quality healthcare services to improve the lives of individuals and communities.

According to JobzMall, the average salary range for a Clinical Reviewer in Eden Prairie, MN, USA is between $60,000 and $80,000 per year. This may vary depending on factors such as years of experience, education level, and specific job responsibilities.

UnitedHealth Group Incorporated is an American for-profit managed health care company based in Minnetonka, Minnesota. UnitedHealth Group, Inc. provides health care coverage, software and data consultancy services. It operates through the following segments: UnitedHealthcare, OptumHealth, OptumInsight, and OptumRx. The UnitedHealthcare segment utilizes Optum's capabilities to help coordinate patient care, improve affordability of medical care, analyze cost trends, manage pharmacy benefits, work with care providers more effectively, and create a simpler consumer experience.