Clinical Reviewer

Welcome to UnitedHealth Group, where we are dedicated to helping people live healthier lives. We are currently seeking a highly qualified and compassionate Clinical Reviewer to join our team. In this role, you will play a critical part in ensuring the quality and accuracy of our healthcare services. You will have the opportunity to make a meaningful impact on the lives of our members and contribute to our mission of making healthcare more accessible and affordable. If you have a strong background in clinical review and a passion for improving healthcare, we encourage you to apply for this exciting opportunity.

1. Conduct comprehensive and thorough reviews of medical records and healthcare services to ensure accuracy and quality.
2. Utilize clinical knowledge and expertise to identify and address any potential discrepancies or concerns in medical documentation.
3. Collaborate with healthcare professionals and other team members to gather and analyze relevant information for review.
4. Evaluate medical records against established guidelines and protocols to determine appropriate levels of care and treatment.
5. Make recommendations for improvement and provide feedback to healthcare providers and management as needed.
6. Stay up-to-date on industry standards and best practices in clinical review to ensure compliance and effectiveness.
7. Communicate findings and recommendations clearly and effectively to various stakeholders, including healthcare providers, members, and management.
8. Maintain accurate and detailed records of all reviews and ensure confidentiality of sensitive information.
9. Participate in team meetings and trainings to share knowledge and contribute to the continuous improvement of our processes.
10. Embrace and promote the mission and values of UnitedHealth Group, including a commitment to helping people live healthier lives.

According to JobzMall, the average salary range for a Clinical Reviewer in Raleigh, NC, USA is $60,000 to $80,000 per year. This may vary depending on factors such as job experience, level of education, and specific company or organization. Salaries may also be influenced by the specific industry or field of work, as well as demand for skilled professionals in the area. It is important to research and compare salaries for similar positions in the Raleigh area to get a better understanding of the average salary range for a Clinical Reviewer.

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.