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Weekday Optum Utilization Review Jobs in Minnesota

UnitedHealth Group

SSBV Clinical Claim Review RN

Plymouth, MN · On-site

$28.94 - $51.83/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Optum is a global organization that delivers care, aided by technology to help millions of people ... A background in utilization review for an insurance company or experience in case management

UnitedHealth Group

SSBV Clinical Claim Review RN

Plymouth, MN · Remote

$28.94 - $51.83/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Optum is a global organization that delivers care, aided by technology to help millions of people ... A background in utilization review for an insurance company or experience in case management

Vivian Health

MDS RN Nurse in Royalton, MN

Royalton, MN · On-site

$10K/mo

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Day Shift Hours - weekdays * The MDS Nurse will work 3 shifts a week as the MDS Nurse and 1 shift a week as an RN Staff Nurse * RN On-call rotation * Previous experience working as an MDS Nurse ...

New

Good Samaritan

MDS - RN Nurse - Woodland - FT - Days

Pierz, MN · On-site

$10K/mo

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Day Shift Hours - weekdays * The MDS Nurse will work 3 shifts a week as the MDS Nurse and 1 shift a week as an RN Staff Nurse * RN On-call rotation * Previous experience working as an MDS Nurse ...

Good Samaritan

MDS - RN Nurse - Woodland - FT - Days

Rice, MN

$10K/mo

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Day Shift Hours - weekdays * The MDS Nurse will work 3 shifts a week as the MDS Nurse and 1 shift a week as an RN Staff Nurse * RN On-call rotation * Previous experience working as an MDS Nurse ...

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All JobsWeekday Optum Utilization Review JobsWeekday Optum Utilization Review Jobs in Minnesota

Weekday Optum Utilization Review information

What is the difference between Weekday Optum Utilization Review vs Weekday Optum Claims Reviewer?

AspectWeekday Optum Utilization ReviewWeekday Optum Claims Reviewer
Primary RoleAssess medical necessity and appropriateness of healthcare servicesReview and process insurance claims for accuracy and compliance
CredentialsTypically requires nursing or healthcare-related certificationsUsually requires insurance or claims processing experience, with some certifications preferred
Work EnvironmentOffice-based, healthcare settings, remote optionsOffice or remote, insurance company environment
Industry UsageHealthcare insurance, utilization managementInsurance claims processing, customer service

While both roles are integral to healthcare insurance operations, Weekday Optum Utilization Review focuses on evaluating the medical necessity of services, whereas Weekday Optum Claims Reviewer handles claims processing and verification. Understanding these differences helps job seekers target the right position based on their skills and credentials.

What are the most commonly searched types of Optum Utilization Review jobs in Minnesota?

The most popular types of Optum Utilization Review jobs in Minnesota are:

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Weekday Optum Utilization Review jobs near you
Infographic showing various Weekday Optum Utilization Review job openings in Minnesota as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Medical Director Oncology - Utilization Management - Remote anywhere in US

UnitedHealth Group

Minneapolis, MN • On-site, Remote

$238K - $357K/yr

Full-time

Retirement

Re-posted 24 days ago

UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

189th of 887 rated healthcare providers

Job description

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
The Medical Director Oncology will provide utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes
  • Serve as a subject matter expert in evidence - based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidence
  • Engage and collaborate with treating providers telephonically; This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense
  • Enhance clinical expertise of the Oncology team through education sessions with nursing teams, and serving as a thought leader and point of contact for relevant medical societies and stakeholders
  • Evaluate clinical and other data (e.g., quality metrics, claims and health record data, utilization data) to identify opportunities for improvement of clinical care and processes
  • Collaborate with operational and business partners on enterprise-wide research and clinical and quality initiatives to enhance Optum impact in the oncology field

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 medical license
  • Obtain additional licenses as needed
  • Current Board Certification in an ABMS or AOBMS specialty in Oncology
  • 5+ years of clinical practice experience (inclusive of Medical Oncology)
  • Experience working with NCCN guidelines
  • Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development, and/or peer review
  • Participate in rotational holiday and call coverage

Preferred Qualification:
  • Experience in managed care and quality management

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
The salary range for this role is $238,000 to $357,500 annually based on full-time employment. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.
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.

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