Optum
Overview
Optum is seeking a licensed Clinical Content Developer (RN, NP, or PA) to develop and update the clinical content of Optum Clinical Products for Medicaid. This fully remote role supports the InterQual suite of products and collaborates with external peer reviewers to ensure content reflects best evidentiary practice standards and meets requirements for various users and contexts. The role also includes quality assurance of content and responding to internal and external client questions.
We are looking for a licensed RN, NP, or PA with a broad clinical background who can join our fully remote team and collaborate on the development of high-quality content for the InterQual suite of products.
You will have the flexibility to work remotely from anywhere within the United States as you tackle challenging projects.
Responsibilities
Utilizing the principles of evidence-based medicine (EBM), design, develop, and update clinical content through critical appraisal and synthesis of information gathered from extensive review of the medical literature and Medicaid State Policy for InterQual content products. Collect and incorporate feedback from external peer reviewers and clients to ensure real-world clinical accuracy and usability
Perform quality assurance of clinical content and create and maintain clinical documentation, as required
Serve as a clinical resource and subject matter expert for both internal and external customers
Leverage AI tools to enhance productivity and innovation by streamlining workflows and automating repetitive tasks. Evaluate emerging trends to drive continuous improvement and strategic innovation.
Collaborate with Product Development (PD), Product Management (PM), Product Owner (PO), and Business Systems Analyst (BSA) as needed
Participate in developing project plans, monitoring tasks, and ensuring on-time delivery of clinical development projects
Participate in field research that contributes to product advancement as needed
Travel limited.
Required Qualifications
Licensed Healthcare professional - RN, NP, PA - with a license in good standing
3+ years of experience in direct patient care
1+ years of experience writing professionally or summarizing clinical research studies
Experience in developing content for prior authorization workflows, especially for Medicaid policies
Understanding of state-specific Medicaid policies and how they intersect with national medical necessity standards, experience in UM/UR specifically for Medicaid LOB
Demonstrated proficiency with various software applications, including but not limited to MS Word, MS Excel, MS PowerPoint
Preferred Qualifications
5+ years of advanced practice experience in inpatient or ambulatory care setting
3+ years of experience in a clinical associated environment or a case management role
Experience with utilization management (UM), case management, or use of evidence-based guidelines such as InterQual/Clinical Decision Support applications or Medicaid State Policies.
Proven willingness to learn and explore new technologies
Research and Evidence-Based Medicine (EBM) knowledge or experience
Proven knowledge of medical coding schemes
Demonstrates ability to adopt technology or has proficiency with various software applications, including but not limited to MS Office suites, Teams, and proprietary software
Proven problem-solving and critical thinking skills; ability to step through logical pathways to arrive at results
Proven solid verbal and written communication skills
Proven results-oriented, effective as both a team member and independent worker with attention to detail and ability to multi-task
All remote employees will be required to adhere to UnitedHealth Group's Telecommuter Policy
Compensation and Benefits 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). The salary for this role will range from $71,200 to $127,200 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.
Equal Employment Opportunity 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.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Marketing, Public Relations, and Writing/Editing
Industries
Hospitals and Health Care
#J-18808-Ljbffr
We are looking for a licensed RN, NP, or PA with a broad clinical background who can join our fully remote team and collaborate on the development of high-quality content for the InterQual suite of products.
You will have the flexibility to work remotely from anywhere within the United States as you tackle challenging projects.
Responsibilities
Utilizing the principles of evidence-based medicine (EBM), design, develop, and update clinical content through critical appraisal and synthesis of information gathered from extensive review of the medical literature and Medicaid State Policy for InterQual content products. Collect and incorporate feedback from external peer reviewers and clients to ensure real-world clinical accuracy and usability
Perform quality assurance of clinical content and create and maintain clinical documentation, as required
Serve as a clinical resource and subject matter expert for both internal and external customers
Leverage AI tools to enhance productivity and innovation by streamlining workflows and automating repetitive tasks. Evaluate emerging trends to drive continuous improvement and strategic innovation.
Collaborate with Product Development (PD), Product Management (PM), Product Owner (PO), and Business Systems Analyst (BSA) as needed
Participate in developing project plans, monitoring tasks, and ensuring on-time delivery of clinical development projects
Participate in field research that contributes to product advancement as needed
Travel limited.
Required Qualifications
Licensed Healthcare professional - RN, NP, PA - with a license in good standing
3+ years of experience in direct patient care
1+ years of experience writing professionally or summarizing clinical research studies
Experience in developing content for prior authorization workflows, especially for Medicaid policies
Understanding of state-specific Medicaid policies and how they intersect with national medical necessity standards, experience in UM/UR specifically for Medicaid LOB
Demonstrated proficiency with various software applications, including but not limited to MS Word, MS Excel, MS PowerPoint
Preferred Qualifications
5+ years of advanced practice experience in inpatient or ambulatory care setting
3+ years of experience in a clinical associated environment or a case management role
Experience with utilization management (UM), case management, or use of evidence-based guidelines such as InterQual/Clinical Decision Support applications or Medicaid State Policies.
Proven willingness to learn and explore new technologies
Research and Evidence-Based Medicine (EBM) knowledge or experience
Proven knowledge of medical coding schemes
Demonstrates ability to adopt technology or has proficiency with various software applications, including but not limited to MS Office suites, Teams, and proprietary software
Proven problem-solving and critical thinking skills; ability to step through logical pathways to arrive at results
Proven solid verbal and written communication skills
Proven results-oriented, effective as both a team member and independent worker with attention to detail and ability to multi-task
All remote employees will be required to adhere to UnitedHealth Group's Telecommuter Policy
Compensation and Benefits 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). The salary for this role will range from $71,200 to $127,200 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.
Equal Employment Opportunity 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.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Marketing, Public Relations, and Writing/Editing
Industries
Hospitals and Health Care
#J-18808-Ljbffr