Clinical Content Developer of Prior Authorization - Remote

Optum; Boston (MA); Remote; USD 71,000 - 128,000; Full time

Job summary

A leading healthcare organization is seeking a Licensed Healthcare Professional to develop clinical content. The role involves ensuring accuracy, collaborating with cross-functional teams, and maintaining high standards in quality assurance. Ideal candidates will have a license in good standing and experience in acute inpatient care, along with strong writing and problem-solving skills. Salary ranges from $71,200 to $127,200 annually.

Qualifications

• Minimum 3 years experience in Acute Inpatient Care.
• Experience in writing with proficiency in synthesizing information.
• Demonstrates solid verbal and written communication skills.

Responsibilities

• Design and update clinical content for the InterQual Level of Care.
• Perform Quality Assurance of clinical content.
• Serve as a clinical resource for customers.

Skills

Evidence-based medicine (EBM)

Clinical writing

Problem-solving skills

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Education

Licensed Healthcare professional (RN, NP, PA)

Tools

MS Office suites

Teams

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.

Primary Responsibilities

• Utilizing the principles of evidence-based medicine (EBM), design, develop, and update clinical content through the critical appraisal and synthesis of information gathered from extensive review of the medical literature for the InterQual Level of Care product line. 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.
• 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 <10%.

Required Qualifications

• Licensed Healthcare professional - RN, NP, PA - with a license in good standing.
• 3+ years of experience in Acute Inpatient Care.
• Experience in writing with strong skills in synthesizing and summarizing information.
• Demonstrated proficiency with various software applications, including but not limited to MS Word, MS Excel, MS PowerPoint.

Preferred Qualifications

• 5+ years of experience in Medical- Surgical or Intensive Care Unit or Primary Care setting.
• 3+ years of experience in a clinical associated environment or a case management role.
• 1+ years of experience writing and summarizing clinical research studies.
• Experience with utilization management (UM), case management, or use of evidence-based guidelines such as InterQual/Clinical Decision Support applications.
• 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 employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including local labor markets, education, work experience, certifications, etc. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and delivering equitable care. 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, and regulations.

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