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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
The Medical Director will partner with cross-functional teams and senior leaders to ensure that Optum leads the industry in innovative health management strategies and is considered an expert in the field of post-acute care. The role as a physician leader, has a proven track record of innovation, achievement of measurable goals, and exceptional clinical competencies. They take a proactive approach to the marketplace and are responsible for continuously reshaping Optum’s corporate wide strategies.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Provide daily utilization oversight and external communication with network physicians and hospitals
Daily UM reviews - authorization and denial reviews
Conduct peer to peer conversations for clinical case reviews as needed
Conduct provider telephonic review and discussion, share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care
Communicate effectively with providers to ensure the successful administering of Optum’s services
Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers
Collaborate with Team to ensure a coordinated approach toward our member’s health care
the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals
Provide leadership and guidance to maximize cost management through close coordination with network and provider contracting
Regularly meet with Optum’s leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues
Provide input on local needs for Analytics Team and Care Management Team to better enhance Optum’s products and services
Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME
Perform other duties and responsibilities as required, assigned, or requested
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 a recognized accredited medical school
Current, unrestricted medical license and residency in the United States
Board certified in a recognized ABMS specialty
Board Certified in Internal Medicine or Physiatry
3+ years of experience practicing in an acute inpatient environment, where dealing with managed care organizations made up at least half of inpatient practice
Proven understanding of population-based medicine with preference given to significant experience with the Medicare, Medicaid, and Commercial populations
Proficient computer skills
Proven working knowledge of changing U.S. payer and provider landscape
Dedicated office/work area established that is separated from other living areas and provides privacy
Reside in a location that can receive a high-speed internet connection
Preferred Qualifications:
Demonstrated ability to work with others while completing multiple tasks simultaneously and successfully
Demonstrated ability to complete assignments with reasonable oversight, direction, and supervision
Demonstrated ability to be highly motivated, flexible, and adaptable to working in a fast-paced, dynamic environment
Demonstrated ability to positively interact with other clinicians, senior management, and all levels of medical and non-medical professionals
Demonstrated ability to quickly adapt to change and drive innovation within team and market
Demonstrated ability to work across functions and businesses to achieve business goals
Demonstrated ability to develop and maintain positive customer and provider relationships
Proven solid interpersonal skills and necessary business acumen to communicate and build positive relationships with management
Proven high level of organizational skills, self- motivation, and ability to manage time independently
Proven excellent organizational, verbal, and written communication and presentation skills
Proven excellent analytic skills
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
The salary range for this role is $269,500 to $425,500 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 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.
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.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.