Top 340 Unitedhealth group Jobs in Boston, Ma

Clinical Claim Review RN
Optum —Boston, MA
- $29 - $52 an hour
- 8 hour shift
- Remote
- 18 years or older
- RN License
- Customer service
- On-the-job training
8d
Care Facilitator (Behavioral Health)
Optum —Quincy, MA
- $20 - $36 an hour
- 8 hour shift
- Hybrid work
- Microsoft Excel
- Computer literacy
- Pass drug screening
- AD&D insurance
- Employee stock purchase plan
9d
Healthcare Representative
Optum —Milton, MA
- $18 - $32 an hour
- Overtime
- 18 years or older
- Spanish
- Hospital
- On-the-job training
Licensed Therapist
UnitedHealth Group —Beverly, MA
- $69,100 - $103,800 a year
- Full-time
- LMFT
- Microsoft Outlook
- Pass drug screening
- Continuing education credits
- Health insurance
Licensed Therapist
UnitedHealth Group —Burlington, MA
- $69,100 - $103,800 a year
- Full-time
- LMFT
- Microsoft Outlook
- Pass drug screening
- Continuing education credits
- Health insurance
Licensed Therapist
UnitedHealth Group —Marlborough, MA
- $69,100 - $103,800 a year
- Full-time
- LMFT
- Microsoft Outlook
- Pass drug screening
- Continuing education credits
- Health insurance
Expanded Practice Support Assistant
Optum —Quincy, MA
- $18 - $32 an hour
- Full-time
- Hybrid work
- Private practice
- Pass drug screening
- Mid-level
- AD&D insurance
- Employee stock purchase plan
Clinical Appeals RN
Optum —Boston, MA
- $28.94 - $51.83 an hour
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- AD&D insurance
- Employee stock purchase plan
Practice Support Assistant II (Part-Time)
Optum —Chestnut Hill, MA
- $18 - $32 an hour
- Part-time
- Pass drug screening
- Mid-level
- High school diploma or GED
Patient Care Coordinator (SEIU), Radiology-Kenmore-Atrius Health
Optum —Boston, MA
- $18.91 - $29.88 an hour
- Full-time
- Computer literacy
- Pass drug screening
- HIPAA
Quick Apply
Community Services Coordinator
Optum —Braintree, MA
- $18 - $32 an hour
- Full-time
- Bilingual
- Microsoft Excel
- Pass drug screening
- AD&D insurance
- Employee stock purchase plan
Sales Readiness, Associate Director - Remote
Optum —Boston, MA
- $112,700 - $193,200 a year
- Full-time
- Remote
- Microsoft Excel
- Pass drug screening
- 3 years
12d
Supervisor, Operational Services II - Atrius Health
Optum —Wellesley, MA
- $60,200 - $107,400 a year
- Full-time
- Word processing
- Computer literacy
- BLS Certification
Quick Apply
VP Business Development Executive - State Government - Remote
Optum —Boston, MA
- $195,000 - $215,000 a year
- Full-time
- Remote
- Pass drug screening
- Driver's License
- Travel
Specimen Processor
Optum —Needham, MA
- $16 - $29 an hour
- Full-time
- Pass drug screening
- High school diploma or GED
- Epic
Practice Support Assistant II
Optum —Wellesley, MA
- $17.98 - $32.12 an hour
- Full-time
- Hybrid work
- Pass drug screening
- Mid-level
- High school diploma or GED
- AD&D insurance
- Employee stock purchase plan
Patient Care Coordinator Per Diem
Optum —Framingham, MA
- $18 - $32 an hour
- Full-time
- Pass drug screening
- Mid-level
- High school diploma or GED
Associate Director, Social Media - Remote
UnitedHealth Group —Boston, MA
- $112,700 - $193,200 a year
- Full-time
- Hybrid work
- Pass drug screening
- HIPAA
- Office
Sr Utilization Management Nurse RN - Field Position
Optum —Boston, MA
- $72,800 - $130,000 a year
- Full-time
- Nursing
- RN License
- Computer literacy
RN Field Clinical Care Coordinator - Central Boston
UnitedHealthcare —Boston, MA
- $29 - $52 an hour
- Full-time
- Nursing
- Microsoft Outlook
- RN License
- AD&D insurance
- Employee stock purchase plan

I want to receive the latest job alert for unitedhealth group in boston, ma

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

unitedhealth group jobs near boston, ma

Patient Care Coordinator jobs in Boston, MA

Patient Care Coordinator jobs in Framingham, MA

Specimen Processor jobs in Needham, MA

Registered Nurse jobs in Boston, MA

Therapist jobs in Beverly, MA

Clinical Nurse jobs in Boston, MA

Therapist jobs in Marlborough, MA

Sales Director jobs in Boston, MA

Social Media Specialist jobs in Boston, MA

Clinical Nurse Coordinator jobs in Boston, MA

Vice President Of Business Development jobs in Boston, MA

Occupational Therapist jobs in Milwaukee, WI

Massage Therapist jobs in Cleveland, OH

College Mental Health Therapist jobs in Los Angeles, CA

Music Therapist jobs in California

Physical Therapist jobs in Grand Junction, CO

Occupational Therapist Aide jobs in New Jersey

Respiratory Therapist jobs in Birmingham, AL

Patient Care Coordinator jobs in Fayetteville, NC

Patient Care Coordinator jobs in White Plains, NY

Clinical Claim Review RN

Optum -
Boston, MA

Apply Now

Job Details

Full-time
$29 - $52 an hour
8 days ago

Benefits

On-the-job training

Qualifications

Confidential information handling
Spreadsheets
Driver's License
Document review
Productivity software
Documentation review
Documentation reviews
Nursing
Excel data analysis

Full Job Description

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

The Clinical Claim Review RN will be responsible for performing compliance reviews of medical and administrative documentation to identify instances of healthcare fraud and/or wasteful and abusive conduct by health care providers who submit claims for payment. This position will utilize information from claims data analysis, plan members, the medical community, law enforcement, employee conduct, and confidential investigations in order to document relevant findings. The Clinical Claim Review RN will conduct site visits and desk audits of provider claims, and medical and administrative records, to gather and analyze all necessary information to determine whether subject adhered to state and federal compliance policies, reimbursement policies, and contract compliance. The Sr. Recovery Resolution Analyst will present and discuss audit findings with clients and input information into Optum audit workflow tools and the client's case tracking system. Where applicable, the Auditor will support appeal and fraud investigation activities.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule.

This position is Remote in Massachusetts. You will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

Review medical and administrative records for audit/compliance review
Travel to provider sites up to 25%/month to collect records and engage with providers
Present and participate in discussions with the client regarding audit observations and findings
Collaborate with a team of 2-5 auditors to complete reviews
Enter audit findings data and notes in online/electronic platform using Excel-based templates
Attend and participate in dispute reviews and administrative hearings
Demonstrated written and verbal communications skills
Demonstrated customer service skills

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

High School Diploma/GED OR equivalent work experience
Nurse licensure (RN or LPN) with a current, active, and unrestricted license in Massachusetts
2+ years of experience reviewing health care documentation in a clinical or administrative role
Experience with MS Office Suite, specifically Word, PowerPoint, and Excel (including familiarity with basic formulas and data analysis)
Ability to travel up to 25% of the time within the state of Massachusetts as business needs dictate
Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm local time. It may be necessary, given the business need, to work occasional overtime
Must have a valid driver's license
Must be 18 years of age OR older

Preferred Qualifications:

Clinical or administrative experience in long term care, for example, nursing facility care delivery/administration and/or community-based LTC service programs like Home Health
Experience in claim processing, healthcare provider information, and healthcare billing practices
Experience working in a remote/telecommute workspace
Working knowledge of medical terminology and claim coding with familiarity of CPT-4, HCPCs and ICD-10 code terminology
Familiarity with Medicaid program and/or billing requirements

Telecommuting Requirements:

Reside within Massachusetts
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Join a team that's committed to shaping the future of health care. Help improve life for millions as you do your life's best work
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29 - $52 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN

Apply Now

Refine Your Search

unitedhealth group jobs in boston, ma

Clinical Claim Review RN

Care Facilitator (Behavioral Health)

Healthcare Representative

Licensed Therapist

Licensed Therapist

Licensed Therapist

Expanded Practice Support Assistant

Clinical Appeals RN

Practice Support Assistant II (Part-Time)

Patient Care Coordinator (SEIU), Radiology-Kenmore-Atrius Health

Community Services Coordinator

Sales Readiness, Associate Director - Remote

Supervisor, Operational Services II - Atrius Health

VP Business Development Executive - State Government - Remote

Specimen Processor

Practice Support Assistant II

Patient Care Coordinator Per Diem

Associate Director, Social Media - Remote

Sr Utilization Management Nurse RN - Field Position

RN Field Clinical Care Coordinator - Central Boston

I want to receive the latest job alert for unitedhealth group in boston, ma

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected