Published
February 3, 2020
Location
Remote, United States of America
Job Type
Work Setting
Remote / Home-based

Description

Medical Director careers at UnitedHealth Group are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. Instead of seeing one patient at a time, you have the opportunity to impact health care trend across the population with data driven information and tools to drive evidence based care. Join us. And start doing your life's best work.(sm)

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Act as the lead physician reviewer with primary responsibility for UMR and OHUM case reviews averaging 10-20 per day, focused on utilization, case, and disease management
  • Support case management team to achieve optimal clinical outcomes for high risk populations
  • Proficient in evidence based clinical guidelines and lead grand round clinical education sessions with nursing teams
  • Primary functions include RN case manager support, and consultation about high risk members, and assisting in account management team external presentations
  • Be involved in telephonic outreach for collaboration with treating providers. This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expenses
  • Responsible to collaborate with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations
  • Effectively engage and articulate the Optum and UHC value story to our external constituents such as physicians and our customers. There may also be opportunities to engage medical and specialty societies, hospitals and hospital associations, and state regulators
  • Deliver the clinical value proposition focused on quality, affordability and service, in support of the sales and growth activities including conducting Broker / Client presentations and participating in customer consultations

By providing 70 million Americans with information, tools and solutions, we are helping to guide them through the health care system, financing their health care needs, and enabling them to achieve their personal health and well-being goals

 

At Optum, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined

 

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 in the state of California
  • Current Board Certification in an ABMS or AOBMS specialty
  • Extensive knowledge/experience of UM processes, systems, and preferably actively performing UM functions
  • Excellent written and oral communication skills

Preferred Qualifications:

  • 5+ years clinical practice experience
  • 2+ years managed care, Quality Management experience and/or administrative leadership experience

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

 

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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