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Optum Clinical Review Jobs (NOW HIRING)

Optum

Optum NY - Radiologic Technologist

Brooklyn, NY

$23.41 - $41.83/hr

$10,000 Sign on Bonus for External Candidates At Optum, you'll have the clinical resources, data ... Processes images and reviews them for proper identification and quality control * Prepares images ...

Optum

Mental Health Clinician

San Diego, CA · On-site

As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make ... Receives and reviews clinical screenings, linkage and levels of care requests * Assist in ...

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How much do optum clinical review jobs pay per hour?

As of Jun 17, 2026, the average hourly pay for optum clinical review in the United States is $34.62, according to ZipRecruiter salary data. Most workers in this role earn between $16.59 and $32.93 per hour, depending on experience, location, and employer.

What is an Optum Clinical Review job?

An Optum Clinical Review job involves evaluating medical records and clinical information to ensure healthcare services meet necessary guidelines and policies. Clinical reviewers assess prior authorization requests, medical necessity, and adherence to regulatory standards. They work with healthcare providers, insurance plans, and internal teams to support accurate and efficient patient care decisions. Typically, these roles require medical or nursing expertise, such as an RN, LPN, or other healthcare professional background. The goal is to balance quality patient care while managing cost-effectiveness and compliance.

Does Optum pay well?

Optum Clinical Review positions typically offer competitive salaries within the healthcare industry, with pay rates varying based on experience, location, and specific role responsibilities. Employees often report that compensation is aligned with industry standards for healthcare review and clinical roles, and benefits may include health insurance and professional development opportunities.

What types of cases or reviews does an Optum Clinical Review professional typically handle?

As an Optum Clinical Review professional, you'll primarily assess requests for medical services, procedures, and hospitalizations to determine medical necessity, appropriateness, and compliance with coverage guidelines. This includes reviewing prior authorizations, concurrent and retrospective reviews, and appeals for a variety of specialties and settings. The role requires a thorough understanding of clinical documentation and payer policies, and often involves collaboration with physicians, case managers, and other healthcare team members. While the majority of work may be desk-based, your clinical judgment plays a key role in ensuring patients receive evidence-based care within established benefit limits.

What jobs pay $10,000 a month without a degree?

High-paying jobs that can reach $10,000 a month without a degree include roles such as sales managers, real estate brokers, commercial pilots, and certain skilled trades like electricians or plumbers with experience. These positions often require specialized skills, certifications, or extensive experience, and income can vary based on performance and location.

What jobs pay 2000 a day?

Jobs that can pay $2,000 a day typically include high-level consulting, specialized medical professionals such as surgeons or anesthesiologists, and certain executive roles. These positions often require advanced skills, certifications, or extensive experience, and may involve freelance or contract work with high hourly rates or project-based payments.

What is an Optum clinical review?

An Optum clinical review is a process where healthcare professionals evaluate medical records, treatment plans, and patient information to determine appropriate care, coverage, or reimbursement. This role requires strong knowledge of medical guidelines, attention to detail, and often involves using electronic health record systems. It is essential for ensuring compliance with healthcare policies and optimizing patient outcomes.

What are the key skills and qualifications needed to thrive in the Optum Clinical Review position, and why are they important?

To thrive as an Optum Clinical Review professional, you need a strong clinical background, an active RN or other clinical license, and experience in medical assessment and utilization management. Familiarity with health insurance platforms, medical coding systems (like ICD-10 and CPT), and electronic medical records is typically required. Excellent attention to detail, strong analytical thinking, and effective communication with both clinicians and non-clinical staff are valued soft skills. These competencies ensure review accuracy and compliance, support quality patient outcomes, and improve collaboration within a fast-paced healthcare environment.

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What cities are hiring for Optum Clinical Review jobs? Cities with the most Optum Clinical Review job openings:
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Optum Clinical Review jobs near you
Infographic showing various Optum Clinical Review job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 83% In-person, and 17% Remote job distribution, with an average salary of $72,002 per year, or $34.6 per hour.
Clinician Team Lead - Clinical Informatics - Optum New Mexico

Clinician Team Lead - Clinical Informatics - Optum New Mexico

UnitedHealth Group

Rio Rancho, NM • On-site

Full-time

Retirement, PTO

Posted yesterday

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 141 frontline employees who took The Breakroom Quiz

187th of 872 rated healthcare providers

Job description

Optum NM is seeking a Clinician Team Lead - Clinical Informatics to join our team in Albuquerque, NM. Optum is a clinician-led care organization that is changing the way clinicians work and live.
As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.
At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.
The Clinician Team Lead, Clinical Informatics is a member of the clinic leadership team who provides leadership and direction to clinic providers in collaboration with their Associate Medical Director and dyad operations partners. The Team Lead is responsible for driving MA growth, improving quality metrics, driving patient safety, and supporting lean process improvements and standard work. The Team Lead continues to have clinical responsibilities in addition to their administrative role. This position is allotted 4 hours Team Lead administrative time weekly.
Primary Responsibilities:
  • Provides diagnosis, treatment, therapy, and management of patients according to current standards of care utilizing best evidence-based practice recommendations
  • Works collaboratively with the patient to provide a Patient-Centered approach to care, adhering to the organization's Patient-Centered mission
  • Drives organization-specific initiatives including Quality (STAR, HEDIS, CAPHS/HOS) and Affordability, and ensures that the processes and procedures are in line with the approved business model
  • Ensures quality indicators are being met and continuously improved by participating in Quality Meetings. Outlines objectives for clinic team members to ensure quality indicators are defined and understood in order to be achieved
  • Supervises clinician team members, including coordination of paid time off, CME time and expense approvals, OLCM license review, and clinician/patient complaint management. Team Leads will meet with direct reports monthly. They will provide performance reviews quarterly with monthly touchpoints
  • Partners with Operations leadership to ensure the success of the clinic team within the clinics.
  • Ensures clinician team members are in compliance with Optum policies and procedures and serves as the liaison between clinicians and the People Team for policy interpretation
  • Performs annual evaluations and participates in creating MAP and developmental goals for the clinician team members as well as participates in company-led initiatives, leadership readiness, and job expansion activities of assigned clinician team members
  • Participates in various committees as assigned and disseminates information timely to all team members
  • Assists in team member recruiting and retention efforts by identifying clinic needs and developing a succession plan for primary care
  • Promotes patient safety and partners with operational leadership to ensure clinic compliance
  • Utilizes evidence-based care processes to meet affordability goals
  • Is accountable for clinic customer satisfaction scores, reviews, and action plans
  • Develops and promotes organization's culture in clinic team members
  • Optimizes clinician productivity and performance
  • Serves as a clinical subject matter expert bridging frontline care delivery and health IT systems
  • Partners with providers, operations, and IT to optimize EHR workflows, templates, order sets, and clinical decision support
  • Leads analysis, design, testing, and implementation of clinical informatics initiatives and system enhancements
  • Identifies workflow inefficiencies and translate clinical requirements into actionable technical specifications
  • Supports quality, safety, population health, and value based care initiatives through data driven solutions
  • Provides clinician education, go live support, and ongoing optimization for informatics tools and workflows
  • Participates in governance, change management, and prioritization of informatics requests
  • Monitors outcomes and adoption metrics to ensure clinical solutions meet operational and patient care goals
  • Performs all other duties as assigned

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:
  • Graduate of an accredited medical school with a M.D. or D.O. degree and completion of an accredited residency program
  • Minimum 2 years of experience in outpatient primary care medicine
  • 1-2 years of management experience or have exhibited appropriate leadership potential
  • Experience in medical utilization management, medical quality assurance, quality improvement techniques, risk management, and compliance
  • Board certification or Board Eligible in Internal or Family Medicine
  • BLS certification required within 30 days of hire.
  • Must be able to meet all pre-employment requirements.
  • Must be able to meet all health requirements at hire and periodically thereafter, as required by company policy/state regulations to verify that they/he/she is free from communicable disease and physically able to perform assigned duties
  • Knowledge of primary care operations; knowledge of management practices, human relations, consensus building, and collaborative ability.
  • Must have strong oral and written communication techniques and be professionally respected by peers; leadership ability and demonstrated competence in the primary care setting

The salary range for this role is $226,000 to $366,000 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
OptumCare 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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