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Supervisor - Clinical Appeals - Central Region

UnitedHealth Group

San Antonio, TX
Job Code:
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Job Details

Supervisor - Clinical Appeals - Central Region(Job Number:729152)

Bring your skills and talents to a role where you’ll have the opportunity to make an impact on a huge scale. Join us. Take this opportunity to start doing your life's best work.(sm)
Primary Responsibilities:
  • Identifies the appropriate work processes to support continuous compliance
  • Maintains Current operational knowledge of regulatory compliance
  • Manages staff to consistently accomplish desired results
  • Manages staff and operations; including recruitment/coaching/hiring/terminations
  • Monitors compliance and quality work product
  • Establish performance measures
  • Conduct performance reviews
  • Motivation and recognition of staff
  • Maintain High level of morale and performance
  • Clinical Appeals (analyzing, reviewing and evaluating appeals, quality of care concerns (grievances)
  • Clinical Interface / Liaison (clinical problem solver with facilities, providers, carriers; resolution of issues concerning members, benefit interpretation, program definition and clarification)
  • Clinical Operations Analysis (monitors and analyzes medical management activities; provides analytical support to clinical programs; may perform clinical assessments and clinical audits)
  • Clinical Training (planning, coordinating, delivering and evaluating clinical training)
  • Clinical Writing (writing nursing tools and reference information to support the design of clinical products and services) - Generally work is self - directed and not prescribed
  • Works with minimal guidance; seeks guidance on only the most complex tasks
  • Assesses and interprets customer needs and requirements

Job Clinical Appeals-SCA
Primary Location US-TX-San Antonio
Other Location 
Organization Clinical Appeals & Grievances
Schedule Full-time
Number of Openings 1
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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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