RN Clinical Policy Writer & Utilization Lead

UnitedHealth Group; Minnesota; Remote; USD 92,000 - 164,000; Full time

Job summary

UnitedHealth Group, based in Minnetonka, MN, seeks a Clinical Consultant RN, Medical Policy Writer to provide clinical leadership for Optum products, develop utilization management guidelines, and support the launch of new offerings.

The ideal candidate holds a Bachelor's degree in nursing, has 3+ years of experience in medical literature search and analysis, and 3+ years in clinical writing such as medical policies or utilization guidelines, plus experience presenting to professional audiences.

Qualifications

• 3+ years of experience with scientific/medical literature search/retrieval/analysis.
• 3+ years of experience with clinical writing such as medical policies or utilization management guidelines.
• Experience with public speaking and delivering presentations to professional audiences.

Responsibilities

• Research and develop product-specific clinical utilization management guidelines.
• Create selection criteria for products with a centers of excellence (COE) network.
• Plan and execute annual expert panels for assigned Optum products.
• Contribute to decision-making during annual network qualification for assigned products.
• Conduct quality of care investigations of adverse outcomes/events.
• Develop medical billing code sets for claims-based product analyses.
• Provide clinical support in the development and market launch of new Optum products.
• Support CSI survey coordinators during product-specific network status qualification processes.

Skills

Clinical research

Clinical writing

Public speaking

Education

Bachelor's degree in nursing

Job description

UnitedHealth Group, based in Minnetonka, MN, seeks a Clinical Consultant RN, Medical Policy Writer to provide clinical leadership for Optum products, develop utilization management guidelines, and support the launch of new offerings.

The ideal candidate holds a Bachelor's degree in nursing, has 3+ years of experience in medical literature search and analysis, and 3+ years in clinical writing such as medical policies or utilization guidelines, plus experience presenting to professional audiences.