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Clinical Content Developer of Prior Authorization - Remote

Remote, USA Full-time Posted 2025-11-24
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. The licensed Clinical Content Developer RN, NP, PA develops and updates the clinical content of Optum Clinical Products. Using critical appraisal and review of medical literature, synthesis of clinical information, and data analysis and with collaboration of external peer reviewers, their role is to ensure the clinical content represents best evidentiary practice standards and will meet requirements for different users, applications, and contexts. The Clinical Content Developer is also responsible for quality assurance (QA) of the content and for responding to internal and external client questions and concerns. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 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%25 You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. 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 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). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. 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. 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. Apply tot his job Apply To this Job

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