Green Card Claims Director Jobs
Claims Director jobs with green card sponsorship require employers to complete PERM labor certification with the Department of Labor before filing an I-140 petition with USCIS. These senior insurance and risk management roles typically qualify under EB-2 for advanced-degree professionals or EB-3 for experienced candidates, leading to lawful permanent residency.
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Get Access To All JobsINTRODUCTION
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.
Here at Optum, we have an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.
ROLE AND RESPONSIBILITIES
The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.
The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director physician to ensure that the appropriate and most cost effective quality medical care is provided to members.
You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
- Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
- Engage with requesting providers as needed in peer-to-peer discussions
- Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
- Participate in daily clinical rounds as requested
- Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
- Communicate and collaborate with other internal partners
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.
BASIC QUALIFICATIONS
- M.D. or D.O.
- Active unrestricted medical license and ability to obtain additional state medical licenses as needed
- Current board certification in Medicine through ABMS or AOA
- 5+ years of physician clinical practice experience after completing residency training
- Proven sound understanding of Evidence Based Medicine (EBM)
- Demonstrated PC skills, specifically using MS Word, Outlook, and Excel
PREFERRED QUALIFICATIONS
- Compact License
- Experience in utilization review
- Demonstrated data analysis and interpretation aptitude
- Proven innovative problem-solving skills
- Proven excellent presentation skills for both clinical and non-clinical audiences
- Demonstrated excellent oral, written, and interpersonal communication skills, facilitation 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). The salary for this role will range from $248,500 to $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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
INTRODUCTION
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.
Here at Optum, we have an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.
ROLE AND RESPONSIBILITIES
The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.
The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director physician to ensure that the appropriate and most cost effective quality medical care is provided to members.
You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
- Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
- Engage with requesting providers as needed in peer-to-peer discussions
- Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
- Participate in daily clinical rounds as requested
- Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
- Communicate and collaborate with other internal partners
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.
BASIC QUALIFICATIONS
- M.D. or D.O.
- Active unrestricted medical license and ability to obtain additional state medical licenses as needed
- Current board certification in Medicine through ABMS or AOA
- 5+ years of physician clinical practice experience after completing residency training
- Proven sound understanding of Evidence Based Medicine (EBM)
- Demonstrated PC skills, specifically using MS Word, Outlook, and Excel
PREFERRED QUALIFICATIONS
- Compact License
- Experience in utilization review
- Demonstrated data analysis and interpretation aptitude
- Proven innovative problem-solving skills
- Proven excellent presentation skills for both clinical and non-clinical audiences
- Demonstrated excellent oral, written, and interpersonal communication skills, facilitation 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). The salary for this role will range from $248,500 to $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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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Get Access To All JobsTips for Finding Green Card Sponsorship in Claims Director
Align your credentials to EB-2 or EB-3
Pull your official transcripts and employment records before applying. EB-2 requires a master's degree or a bachelor's plus five years of progressive experience in claims leadership. EB-3 covers a bachelor's degree with at least two years of qualifying experience.
Search verified PERM-sponsoring employers on Migrate Mate
Filter Claims Director roles by employers with documented PERM filing history on Migrate Mate. Targeting companies that have already completed the DOL recruitment and prevailing-wage process for similar roles shortens your path to an I-140 significantly.
Request a prevailing wage tier before negotiations
Ask your prospective employer which OFLC Wage Search tier they plan to certify at. PERM requires the offered salary to meet or exceed the prevailing wage for your SOC code and location, so knowing the tier early protects you from an offer that fails DOL certification.
Distinguish PERM recruitment timelines from your start date
Employers must complete a DOL-mandated recruitment test before filing PERM, which typically takes several months. Negotiate your start date separately from the PERM filing date so you're not waiting on DOL certification before you can begin the role.
Verify your O*NET occupational match before interviews
Claims Director maps to specific SOC codes in O*NET. Confirm your resume's listed duties align with the O*NET task descriptions for the role, because PERM audits compare the job description against the standard occupation definition.
Preserve your priority date if you change employers
Once USCIS approves your original I-140, your priority date becomes portable to a new employer's I-140. If your I-485 has been pending 180 days or more, AC21 portability also lets you move to a same or similar occupation without restarting the green card process.
Green Card Claims Director: Frequently Asked Questions
What green card category applies to a Claims Director role?
Most Claims Director positions qualify under EB-2 if you hold a master's degree or a bachelor's degree with five years of progressive claims leadership experience. Roles requiring only a bachelor's degree and at least two years of experience fall under EB-3. Your employer's PERM filing will specify the category based on the actual minimum requirements of the position.
How does green card sponsorship differ from H-1B for this role?
H-1B visa is a temporary nonimmigrant status requiring renewal and tied to a specific employer, with no permanent residency outcome on its own. Green card sponsorship via EB-2 or EB-3 leads directly to lawful permanent residence. It requires PERM labor certification with the Department of Labor, an I-140 petition with USCIS, and either adjustment of status or consular processing. There is no lottery, but per-country annual limits mean nationals of high-demand countries may face priority-date backlogs before final approval.
How do I find Claims Director jobs with green card sponsorship?
Migrate Mate lists Claims Director roles at employers with verified PERM filing history, so you can focus your applications on companies that have already demonstrated willingness to sponsor. Searching by role and location surfaces employers who have completed DOL labor certification for similar positions, reducing the risk of pursuing opportunities where sponsorship is uncertain.
What is the PERM process and how long does it take for a Claims Director position?
PERM, or Program Electronic Review Management, is the DOL labor certification process that requires your employer to conduct a formal recruitment test, obtain a prevailing wage determination, and demonstrate no qualified U.S. workers are available for the role. DOL reviews the application before the employer can file an I-140 with USCIS. Processing times vary and are subject to DOL audit queues, so your employer should file well before you need permanent status secured.
Can I change employers after my green card process has started?
Two distinct rules govern this. If USCIS approves your original I-140, your priority date is preserved and a new employer can file a fresh I-140 using that date. Separately, if your I-485 has been pending for 180 days or more, AC21 portability allows you to move to a same or similar occupation without restarting the entire process. Confirm the SOC code alignment between your old and new Claims Director role before invoking portability.