Clinical Reviewer

Are you looking for a challenging and rewarding career in the healthcare industry? UnitedHealth Group is seeking a Clinical Reviewer to join our team and make a difference in the lives of our members. As a Clinical Reviewer, you will have the opportunity to utilize your clinical expertise to ensure the delivery of quality care to our members. We are seeking a highly motivated and detail-oriented individual with a passion for improving healthcare outcomes. If you have a strong background in healthcare and are looking for a dynamic and fast-paced work environment, we encourage you to apply for this exciting opportunity.

1. Conduct clinical reviews of medical records to ensure the delivery of quality care to members.
2. Utilize clinical expertise and knowledge to identify gaps in care and make recommendations for improvement.
3. Collaborate with healthcare providers to ensure appropriate treatment plans are in place for members.
4. Analyze data and trends to identify opportunities for process improvement and cost savings.
5. Stay updated on industry trends and best practices to ensure the highest level of care for members.
6. Communicate with healthcare providers, members, and internal teams to gather necessary information and provide updates on review progress.
7. Maintain accurate and detailed documentation of reviews and recommendations.
8. Adhere to all confidentiality and privacy regulations in handling sensitive member information.
9. Participate in team meetings and training sessions to stay informed on policies, procedures, and updates in the healthcare industry.
10. Act as a subject matter expert and resource for other team members.
11. Continuously seek ways to improve processes and increase efficiency.
12. Uphold company values and mission while representing UnitedHealth Group in a professional manner.

According to JobzMall, the average salary range for a Clinical Reviewer in Chicago, IL, USA is between $75,000 to $90,000 per year. This can vary depending on factors such as experience, education, and the specific industry or company one works for. Some clinical reviewers may also receive additional benefits such as bonuses, healthcare, and retirement plans.

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.