Medical Director - Optum - Virtual

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)
 
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 and disease management teams 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

Provide Cross Coverage for UM Medical Director for activities in the UMR and OHUM case queue. 

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

Required Qualifications:

MD or DO with an active, unrestricted medical license
Current Board Certification in an ABMS or AOBMS specialty
Extensive knowledge/experience of UM processes, systems, and preferably actively performing UM functions
5+ years clinical practice experience
2+ years managed care, Quality Management experience and/or administrative leadership experience
Excellent written and oral communication skills
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)
 

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.