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Clinical Dental Appeals, (RDH) Registered Dental Hygienist - Santa Ana, CA or Cypress, CA

UnitedHealth Group


Location:
Santa Ana, CA
Date:
09/05/2017
2017-09-052017-10-04
Job Code:
1775926
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Job Details


Clinical Dental Appeals, (RDH) Registered Dental Hygienist - Santa Ana, CA or Cypress, CA(Job Number:726312)
Description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

 

In collaboration with, and supervision by the Clinical Appeals RDH.   The Registered Dental Hygienist (RDH) is responsible for ongoing clinical review and recommendation of appeals and grievances cases for UnitedHealthcare associated companies. Performance accountabilities include:
 

Primary Responsibilities:

  • Work as part of an integrated team of dental director dentists, other functional areas, and other members of the appeals staff
  • Perform individual case review for appeals and grievances for various health plan and insurance products, which may include Indemnity, PPO, ASO, and HMO, The appeals are in response to adverse determinations for dental services related to benefit design and coverage, dental necessity, and the application of clinical criteria of dental policies
  • Communicate with UnitedHealthcare Clinical Appeals RDH Manager and dental directors regarding appeals recommendation rationales and benefit interpretations
  • Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results
  • Participating in organizational committees, projects, and task forces, as appropriate

 


Job MEDICALMGMT CLINICAL REVIEW
Primary Location US-CA-Santa Ana
Other Location US-CA-Santa Ana, US-CA-Cypress
Organization CCR/Prior Authorization/MCR
Schedule Full-time
Number of Openings 3
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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