Physical Medicine & Rehabilitation Physician (PMR) Physiatry – Physicians Only Apply – Perm Position Available In Broward, Florida

Job Description:

A Physical Medicine & Rehabilitation Physician (PMR) Physiatrypractice is seeking a qualified physician for FORT LAUDERDALE, FL.This and other physician jobs brought to you by ExactMD. MedicalDoctors Only Apply. Appeals and Grievances

• Work From Home The Appeals and Grievances Medical Director is responsible forongoing clinical review and adjudication of appeals and grievancescases for UnitedHealthcare associated companies.

Performanceaccountabilities include:

• Perform individual case review for appeals and grievances forvarious health plan and insurance products, which may include PPO,ASO, HMO, MAPD, and PDP. The appeals are in response to adversedeterminations for medical services related to benefit design andcoverage and the application of clinical criteria of medicalpolicies.
• Perform Department of Insurance/Department of Managed Healthcare,and CMS regulatory responses.
• Communicate with UnitedHealthcaremedical directors regarding appeals decision rationales, andbenefit interpretations.
• Communicate with UnitedHealthcare Regional and Plan medicaldirectors and network management staff regarding access,availability, network, and quality issues.
• Actively participate in team meetings focused on communication,feedback, problem solving, process improvement, staff training andevaluation, and the sharing of program results.
• Provide clinical and strategic input when participating inorganizational committees, projects, and task forces.

Qualifications:

• MD or DO with an active, unrestricted license
• Board Certified in an ABMS or AOBMS specialty
• 5+ years clinical practice experience
• Intermediate or higher level of proficiency with managed care
• 2+ years Quality Management experience
• Excellent telephonic communication skills; excellentinterpersonal communication skills.
• Excellent project management skills
• Data analysis and interpretation skills
• Excellent presentation skills for both clinical and non-clinicalaudiences; Familiarity with current medical issues and practices
• Creative problem solving skills
• Basic computer skills, typing, word processing, presentation, andspreadsheet applications skills; Internet researching skills
• Strong team player and team building skills.

Careers with

UnitedHealthcare:

Let’s talk about opportunity. Startwith a Fortune 14 organization that’s serving more than 85 millionpeople already and building the industry’s singular reputation forbold ideas and impeccable execution. Now, add your energy, yourpassion for excellence, your near-obsession with driving change forthe better. Get the picture? UnitedHealthcare is serving employersand individuals, states and communities, military families andveterans where ever they’re found across the globe. We bring themthe resources of an industry leader and a commitment to improvetheir lives that’s second to none. This is no small opportunity.

It’s where you can do your life’s best work.

SM Diversity creates a healthier atmosphere: All qualified applicantswill receive consideration for employment without regard to race,color, religion, sex, national origin, protected veteran status, ordisability status. UnitedHealth Group is a drug-free workplace.

Candidates are required to pass a drug test before beginningemployment. In addition, employees in certain positions are subjectto random drug testing.