Appeals M.D. - Family or Internal Medicine Required - Remote 2369464 | Cypress, California | Remote

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Touch device users, explore by touch or with swipe gestures. Go Explore remote jobs Pursue your passion and potential Appeals M.D. - Family or Internal Medicine Required - Remote Cypress, California + Additional locations Apply Internal apply Bookmark job Jump to Our values Job description Benefits Testimonial Awards & recognitions Related content Caring. Connecting. Growing together. With these values to guide us, our people are committed to making a meaningful difference in the lives of those we are honored to serve. Integrity Compassion Inclusion Relationships Innovation Performance Back to nav Appeals M.D. - Family or Internal Medicine Required - Remote Requisition number: 2369464 Job category: Medical & Clinical Operations Primary location: Cypress, California Additional locations: Phoenix, Arizona | Boston, Massachusetts | Houston, Texas | Chicago, Illinois | Tampa, Florida Date posted: 08/10/2026 Overtime status: Exempt Travel: No Share this job Facebook X LinkedIn Email At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Work at home! You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. Performance accountabilities include: Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations Communicate with UnitedHealthcare Regional and Plan medical directors 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 and evaluation, and the sharing of program results Provide clinical and strategic input when participating in organizational committees, projects, and task forces What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. 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: MD or DO with an active, unrestricted license Board Certified in an ABMS or AOBMS specialty 5+ years of clinical practice experience 2+ years of Quality Management experience Familiarity with current medical issues and practices Intermediate or higher level of proficiency with managed care Proven excellent telephonic communication skills; excellent interpersonal communication skills Proven excellent project management skills Proven data analysis and interpretation skills Proven excellent presentation skills for both clinical and non-clinical audiences Proven creative problem-solving skills Proven basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills Proven solid team player and team building skills *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 $248,500 - $373,000 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 Internal apply Bookmark job Back to nav Benefits Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well. Life Resources and support to focus on what matters most to you, in every facet of your life. Emotional Education, tools and resources to help you reduce and manage stress, build resilience and more. Physical Health plans and other coverage to support wellness for you and your loved ones. Financial Benefits for today and to help you plan for the future, including your retirement. Learn more Back to nav Previous slide The most motivating aspect of my role is to help people live healthier lives. If roles were reversed, I'd want someone I could trust to be there in the moments that matter. Orrin K. Director of Health Plan Operations – Hawaii Making a difference is not about the big things or grand gestures; it's about impacting one person at a time even the smallest way. If I know I've impacted just one person, with a smile, or a kind word, or even a helping hand, then I know I've made a difference. Amaris A. Program Integrity Manager Knowing the company supports both professional and personal growth — like furthering our education — makes me incredibly proud. Jessyca G. Senior Health Advocate The most motivating aspect of my role is to help people live healthier lives. If roles were reversed, I'd want someone I could trust to be there in the moments that matter. Orrin K. Director of Health Plan Operations – Hawaii Making a difference is not about the big things or grand gestures; it's about impacting one person at a time even the smallest way. If I know I've impacted just one person, with a smile, or a kind word, or even a helping hand, then I know I've made a difference. Amaris A. Program Integrity Manager Knowing the company supports both professional and personal growth — like furthering our education — makes me incredibly proud. Jessyca G. Senior Health Advocate The most motivating aspect of my role is to help people live healthier lives. If roles were reversed, I'd want someone I could trust to be there in the moments that matter. Orrin K. Director of Health Plan Operations – Hawaii Next slide Go to slide 1 Go to slide 2 Go to slide 3 Back to nav We’re honored to be recognized for our exceptional work culture Back to nav Discover our family of businesses See how we’re structured to help build a modern, high-performing health system. Learn more Explore our hiring process Learn what to expect when you pursue an opportunity with us. Learn more Committed to sustainability Take a look at all the ways we’re working for a healthier, more sustainable future. 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