Medical Doctors - Clinical Appeals

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.  

Positions in this function are responsible for providing expertise or general support in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances. Communicates with appropriate parties issues, implications and decisions. Analyzes and identifies trends for appeals and grievances. This includes senior level positions with education/certification/licensure other than an RN, such as BSW, MSW, DDS, Chiropractor, Physical Therapist, etc. (Positions responsible for claims appeals can be found in the Claims job family.)

Primary Responsibility:

• Comply with all applicable Company policies, procedures, and business directives, including any changes relating to work location, team assignments, work schedules, and flexible work arrangements.

Required Qualifications:

• Active Medical License/Physician/Medical Director
• Diplomate in Internal Medicine
• 3+ years of Clinical Experience
• Proven track record of building and leading high-performing teams
• Proven solid analytical and problem-solving skills
• Proven excellent communication, interpersonal, and organizational skills
• Willing to work in US Shift and report in any of the sites
• Ability to work onsite

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.