Talent.com
Clinical Review Medical Director - Vascular Surgery - Remote
Clinical Review Medical Director - Vascular Surgery - RemoteUnitedHealth Group • Phoenix, AZ, United States
Clinical Review Medical Director - Vascular Surgery - Remote

Clinical Review Medical Director - Vascular Surgery - Remote

UnitedHealth Group • Phoenix, AZ, United States
30+ days ago
Job type
  • Full-time
  • Remote
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.

Clinical Advocacy & Support has 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.

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 pre-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 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. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

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
  • Call coverage rotation
  • 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 :

  • M.D or D.O.
  • Active unrestricted license to practice medicine
  • Board Certification in Vascular Surgery
  • 5+ years of clinical practice experience after completing residency training
  • Sound understanding of Evidence Based Medicine (EBM)
  • Proven solid PC skills, specifically using MS Word, Outlook, and Excel
  • Preferred Qualifications :

  • Experience in utilization and clinical coverage review
  • Willing to review general surgery cases as well
  • Proven data analysis and interpretation aptitude
  • Proven innovative problem-solving skills
  • Demonstrated excellent presentation skills for both clinical and non-clinical audiences
  • Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills
  • Current licensure in New Mexico, Arizona or Indiana
  • Willing to obtain additional licensures if needed
  • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
  • Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. 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). No matter where or when you begin a career with us, 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.

    Create a job alert for this search

    Vascular Surgery • Phoenix, AZ, United States

    Related jobs
    LAB Director, Commercial Labs Anatomic Pathology

    LAB Director, Commercial Labs Anatomic Pathology

    Sonora Quest Laboratories • Phoenix, AZ, US
    Full-time
    Join the powerhouse behind Arizona's leading diagnostic testing network- Sonora Quest Laboratories, where innovation meets impact. As a strategic thinking experienced anatomic pathology leader, ...Show more
    Last updated: 24 days ago • Promoted
    Physician / Neurology / Arizona / Permanent / Associate Medical Director - Neurology - 100% Remote

    Physician / Neurology / Arizona / Permanent / Associate Medical Director - Neurology - 100% Remote

    eviCore healthcare • Phoenix, AZ, US
    Remote
    Part-time
    Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...Show more
    Last updated: 30+ days ago • Promoted
    Medical Director DME - Remote

    Medical Director DME - Remote

    UnitedHealth Group • Phoenix, AZ, United States
    Remote
    Full-time
    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 connect...Show more
    Last updated: 30+ days ago • Promoted
    Associate Market Medical Director - Phoenix, AZ - Making over $350,000

    Associate Market Medical Director - Phoenix, AZ - Making over $350,000

    Optigy • Phoenix, AZ, US
    Permanent
    Primary Care Associcate Market Medical Director making over $350,000 in Phoenix, AZ.Associate Market Medical Director Job Summary. The Assoc Market Medical Director is an important part of the our H...Show more
    Last updated: 5 hours ago • Promoted • New!
    Outpatient Orthopedic Physical Therapy Clinic Director

    Outpatient Orthopedic Physical Therapy Clinic Director

    Jooble • Phoenix, AZ, US
    Full-time
    Pritchette Physical Therapy •is looking for a full-time Arizona licensed doctor of physical therapy to be the Clinic Director of our Foothills Clinic. ABOUT US • : We currently have two locations in ...Show more
    Last updated: 2 hours ago • Promoted • New!
    Medical Director

    Medical Director

    Arizona Priority Care • Chandler, AZ, US
    Full-time
    Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models.Our provider network is...Show more
    Last updated: 30+ days ago • Promoted
    Gastroenterology IBD Director

    Gastroenterology IBD Director

    Community Health at Home • Phoenix, AZ, United States
    Full-time
    Job Summary and Responsibilities.Dignity Health Medical Group - Arizonaand the Digestive Disease Instituteis actively seeking a dynamic clinical leader with training in Inflammatory Bowel Diseaseto...Show more
    Last updated: 5 days ago • Promoted
    Family Medicine Medical Director Opportunity in Arizona

    Family Medicine Medical Director Opportunity in Arizona

    CompHealth • Phoenix, AZ, United States
    Permanent
    Leadership role with 4 days administrative, 1 day clinical schedule.Oversee provider development and care delivery integration model. Must have 5 years of experience including 2 years in leadership....Show more
    Last updated: 2 days ago • Promoted
    Medical Director Psychiatrist Position in Phoenix, Arizona

    Medical Director Psychiatrist Position in Phoenix, Arizona

    CHG Healthcare • Phoenix, AZ, US
    Permanent
    This position is in Phoenix, AZ, a progressive, innovative city that offers the friendly, caring atmosphere of a small town. The city offers a rich cultural heritage and unique blend of influences f...Show more
    Last updated: 30+ days ago • Promoted
    Senior Medical Director - Psychiatrist - Remote Based

    Senior Medical Director - Psychiatrist - Remote Based

    Syneos Health / inVentiv Health Commercial LLC • Phoenix, AZ, United States
    Remote
    Full-time
    Senior Medical Director - Psychiatrist - Remote Based.Syneos Health is a leading fully integrated biopharmaceutical solutions organization built to accelerate customer success.We translate unique c...Show more
    Last updated: 30+ days ago • Promoted
    Medical Director-Behavioral / Psych- (MD or DO)

    Medical Director-Behavioral / Psych- (MD or DO)

    Adecco • Phoenix, AZ, US
    Full-time
    We are seeking several compassionate and experienced Medical Director.This is an excellent opportunity for a passionate physician to help lead and shape the future of an essential community health ...Show more
    Last updated: 7 days ago • Promoted
    Field Medical Director, Interventional Cardiology (Remote)

    Field Medical Director, Interventional Cardiology (Remote)

    Evolent • Phoenix, AZ, United States
    Remote
    Full-time +1
    Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect...Show more
    Last updated: 30+ days ago • Promoted
    Medical Director Physician

    Medical Director Physician

    FCS, Inc. • Phoenix, AZ, USA
    Full-time
    Serve as a member of the site leadership team, working collaboratively with the Site Administrator, Clinical Director and Lead Nurse regarding site-based service delivery of clinical care.In this i...Show more
    Last updated: 30+ days ago • Promoted
    Physician / Oncology / Arizona / Permanent / Associate Medical Director - Oncology - 100% Remote

    Physician / Oncology / Arizona / Permanent / Associate Medical Director - Oncology - 100% Remote

    eviCore healthcare • Phoenix, AZ, US
    Remote
    Part-time
    Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...Show more
    Last updated: 30+ days ago • Promoted
    Field Medical Director, Pain Management

    Field Medical Director, Pain Management

    Evolent • Phoenix, AZ, United States
    Full-time
    Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect...Show more
    Last updated: 2 days ago • Promoted
    Radiation Oncology Medical Director

    Radiation Oncology Medical Director

    CommonSpirit Health • Phoenix, AZ, United States
    Full-time
    Job Summary and Responsibilities Dignity Health St.Joseph’s Hospital and Medical Center seeks to employ a full-time Medical Director of Radiation Oncology to support our robust oncology program cov...Show more
    Last updated: 30+ days ago • Promoted
    Surgical Technology - Program Director

    Surgical Technology - Program Director

    Jobot • Phoenix, AZ, US
    Full-time +1
    Apply to receive a $5K Sign On Bonus!.This Jobot Job is hosted by : Dexter Dionio.Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.Salary : $85,000 - $90,00...Show more
    Last updated: 20 hours ago • Promoted • New!
    Vascular Surgeon IME Reviewer & Medical Advisor

    Vascular Surgeon IME Reviewer & Medical Advisor

    Dane Street, LLC • Phoenix, AZ, United States
    Full-time
    A healthcare consulting firm is seeking a Physician Reviewer / Advisor for Independent Medical Exams (IME) in Phoenix, Arizona. The role involves reviewing medical records, ensuring compliance with cl...Show more
    Last updated: 5 days ago • Promoted