Sign In
 [New User? Sign Up]
Mobile Version

Social Worker, Prior Authorization - Telecommute in Boston, MA

UnitedHealth Group

Boston, MA
Job Code:
Apply on the Company Site
  • Save Ad
  • Email Friend
  • Print
  • Research Salary

Job Details

Social Worker, Prior Authorization - Telecommute in Boston, MA(Job Number:702819)

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)


***This is a telecommuter position, but it does require that the individual live in the state of Massachusetts and close to one of the offices in the Boston area.***


Primary Responsibilities:

  • Responsible for performing prior authorization review of services that require notification, using applicable benefit plan documents, evidence - based medical policy and state specific recognized clinical guidelines and criteria
  • Determines medical appropriateness of provider services following evaluation of medical guidelines and benefit determination
  • Interacts with providers to obtain clinical information to support prior authorization determinations and provide support for their questions
  • Evaluate applicability of community resources / government programs / LTSS provider services to member needs
  • Navigate relevant computer systems to identify internal and external resources
  • Perform / support clinical appeals (e.g., notes, previous reviews, obtain rationales)

Job Social Work
Primary Location US-MA-Boston
Other Location US-MA-Wakefield, US-MA-AVON, US-MA-Waltham, US-MA-Needham
Organization Optum Government Solutions
Schedule Full-time
Number of Openings 1
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.

Featured Jobs[ View All ]

Featured Employers [ View All ]