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At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
UnitedHealthcare’s Medical Policy team seeks a skilled and experienced Medical Policy Writer to support the development and maintenance of medical policies. This individual will be responsible for drafting medical policies in collaboration with an epidemiologist and medical director, adapting them to different health plans, and maintaining them over time using the latest published medical literature. The ideal candidate will have experience writing medical policies or similar documents, working in close multidisciplinary collaborations, and advancing continuous process innovation and improvement.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Develop and maintain medical policies, which includes:
- Reviewing and interpreting claims trends for services relevant to specific policies
- Identifying high quality, topic-relevant publications (peer reviewed biomedical articles, guidelines, licensed evidence summaries)
- Reviewing relevant publications with other team members, especially the lead physician, to understand strengths and weaknesses and select those most appropriate for policy inclusion
- Drafting and revising the policy (or policy update) with all relevant sections including: coverage rationale, evidence summary, billing and diagnosis codes, definitions, citations
- Collaborate with a larger team of medical policy writers, epidemiologists, physicians, copy editor, publication experts, and implementation experts
- Support continuous refinement and evolution of the medical policy development and maintenance process to drive industry-leading quality, top-of-talent work, and optimal use of modern content development and publication tools
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
- Degree in clinical life sciences, nursing, physical therapy, or related field
- 2+ years of experience in writing medical polices or similar scientific documents
- 2+ years experience in medical management, medical claims review, appeals, or some other utilization management experience
- Demonstrated experience and skill in evaluating the quality and validity of published clinical studies, guidelines and evidence summaries and an ability to identify and report strengths, weaknesses and uncertainties in study design, analytic methods, interpretation of findings and discussion of meaning
- Understanding of medical coding concepts (e.g., CPT, HCPCS, ICD-10)
- Proficiency in Microsoft Applications and working in shared document environment (e.g. SharePoint, Box, Dropbox)
- Demonstrated ability to analyze and translate claims data to develop recommendations for policy specific implications and potential actions
- Proven excellent medical writing skills/ability to write clearly for a diverse audience
- Proven comfort identifying limits of knowledge and skills and escalating appropriately when needed
- Proven solid interpersonal skills and the ability to work collaboratively with a large and diverse team
- Proven proactive attitude with a willingness to learn, innovate, and adapt in a fast-paced work setting
Preferred Qualifications:
- Certified Coder
- Registered Nurse (RN) or other allied medical professional licensure
- 2+ years clinical experience
- Experience using citation management software (e.g., EndNote, Zotero), Microsoft Excel and Word, and cloud-based collaboration tools such as SharePoint or Dropbox in a professional or academic environment
- Research experience in clinical medicine
- Healthcare Policy writing experience
Why Join UnitedHealthcare?
At UnitedHealthcare, we believe in making a difference in the lives of our members. As a Medical Policy Director, you will play a crucial role in ensuring the quality and integrity of our medical policy documents. We offer a collaborative work environment, competitive compensation, ability to work remotely anywhere in the United States, and opportunities for professional growth.
Join us in our mission to help people live healthier lives and make the healthcare system work better for everyone.
*All employees working remotely 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 salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
