Medicaid Navigator

UnitedHealth Group; Makati; On-site; PHP 446,000 - 781,000; Full time

Job summary

UnitedHealth Group's Optum unit in the Philippines is hiring a Clinical Content Specialist to update and develop medical coding algorithms and clinical content. You will work with clinicians and coders to ensure ICD-10, CPT and HCPC codes are applied accurately and deliver high-quality outputs that support care optimization.

The role requires an Associate's degree and 3+ years in a health-related field, strong Office skills, attention to detail, and the ability to manage multiple priorities.

Qualifications

• Associate's degree is required.
• 3+ years in a health-related field (clinical, documentation, claims).
• Knowledge of ICD-10, CPT, HCPC codes.
• Proven ability to learn new workflow tools.
• Strong organizational and communication skills.

Responsibilities

• Update existing algorithms and content, including notes and codes.
• Develop new algorithms by analyzing clinical content and codes.
• QA and proofing of content in the authoring tool to ensure accuracy.
• Comply with employment contracts and company policies; adapt to organizational changes.

Skills

Office software

Medical terminology

Organizational skills

Communication skills

Project management

Attention to detail

Multitasking

Workflow tools

Education

Associate's degree

Bachelor's degree

Licensure/certification in health-related field

SNOMED-CT

LOINC

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Primary Responsibilities:

• Updates existing algorithms based on comparing updates to the existing algorithms and executing the changes required. This may include adding new content, and notes, removing existing content, and/or updating codes
• Develop new algorithms. This is accomplished by analyzing and interpreting the content and creating an algorithm structure that supports an efficient workflow. Includes clinical content, notes, and applicable codes
• Completes QA and proofing of content in the authoring tool to ensure rules function as designed to ensure the accuracy of final product deliverables
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Associate's degree
• 3+ years working in a health-related field; clinical role, clinical documentation specialist, medical coding, medical research or medical claims adjuster
• Knowledge of standard medical code sets; ICD-10, CPT, HCPC
• Specialized Knowledge/Skills
  • Solid computer skills in basic Office applications (Word, Excel, Outlook, etc.)
  • Solid knowledge of medical terminology
  • Excellent organizational, communication, and project management skills
  • Proven solid attention to detail
  • Proven ability to successfully manage multiple priorities with deliverables completed on time and with high-quality
  • Proven ability to learn new workflow tools

Preferred Qualifications:

• Bachelor's degree
• Current licensure/certification in health-related field
• SNOMED-CT, LOINC

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.

Optum is a drug-free workplace. © 2026 Optum Global Solutions (Philippines) Inc. All rights reserved.