Talent.com
UM Medical Director - Family Medicine, Internal Medicine or Sports Medicine - Remote

UM Medical Director - Family Medicine, Internal Medicine or Sports Medicine - Remote

UnitedHealth GroupPhoenix, AZ, United States
15 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 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 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
  • 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 certified in Family Medicine or Internal Medicine and / or Sports Medicine
  • Ability to obtain additional licenses as needed
  • 5+ years of clinical practice experience after completing residency training
  • Proven sound understanding of Evidence Based Medicine (EBM)
  • PC skills, specifically using MS Word, Outlook, and Excel
  • Participate in rotational holiday and call coverage
  • Preferred Qualifications :

  • Experience in utilization and clinical coverage review
  • Demonstrated data analysis and interpretation aptitude
  • Innovative problem-solving skills
  • Proven 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
  • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
  • The salary range for this role is $238,000 to $357,500 per year. 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.

    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

    Internal Medicine • Phoenix, AZ, United States

    Related jobs
    • Promoted
    Medical Director - Hematology or Oncology - Remote

    Medical Director - Hematology or Oncology - Remote

    UnitedHealth GroupPhoenix, 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 moreLast updated: 15 days ago
    • Promoted
    Medical Director DME - Remote

    Medical Director DME - Remote

    UnitedHealth GroupPhoenix, 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 moreLast updated: 26 days ago
    • Promoted
    Associate Manager Medical Imaging Ultrasound

    Associate Manager Medical Imaging Ultrasound

    Banner HealthGlendale, AZ, US
    Full-time
    Help lead health care into the future.Make real change in health care with the freedom to innovate and highly trained staff to execute your vision. Apply today to join the Banner Health leadership t...Show moreLast updated: 13 days ago
    • Promoted
    Physician-Family Medicine (without OB)

    Physician-Family Medicine (without OB)

    Banner HealthCasa Grande, US
    Full-time
    JOIN PRIMARY CARE TEAM AT GROWING CLINIC | CASA GRANDE, AZ.Affordable living, family-friendly, and easy access to year-round outdoor adventures near Phoenix & Tucson. BE / BC Family Medicine or In...Show moreLast updated: 30+ days ago
    • Promoted
    Internal Medicine

    Internal Medicine

    Enterprise Medical RecruitingSurprise, Arizona, US
    Full-time
    Internal Medicine physician employment in Arizona : .Enterprise Medical is representing a community health center with nine sites throughout the Phoenix area. We are scheduling interviews with Intern...Show moreLast updated: 19 days ago
    • Promoted
    Physician (MD / DO) - Family Practice in Litchfield Park, AZ

    Physician (MD / DO) - Family Practice in Litchfield Park, AZ

    LocumJobsOnlineLitchfield Park, AZ, US
    Full-time
    LocumJobsOnline is working with The Inline Group to find a qualified Family Practice MD in Litchfield Park, Arizona, 85340!. New Graduates Welcome to Apply.Average Patients seen : Varies.Compensatio...Show moreLast updated: 30+ days ago
    • Promoted
    Physician-Occupational Medicine

    Physician-Occupational Medicine

    Banner HealthCasa Grande, US
    Full-time
    BANNER HEALTH, one of the countrys premier non-profit health systems, is seeking a BC Physician in either.Occupational Medicine, Internal Medicine, Family Medicine, Emergency Medicine, Preventative...Show moreLast updated: 28 days ago
    • Promoted
    Medical Director

    Medical Director

    Arizona Priority CareChandler, 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 moreLast updated: 30+ days ago
    • Promoted
    Medical Director

    Medical Director

    National Veterinary AssociatesMESA, Arizona, United States
    Permanent
    We are seeking a Medical Director to lead our practice at Brown Road Animal Clinic located in the heart of Mesa.We have been dedicated to providing exceptional veterinary services to companion anim...Show moreLast updated: 19 days ago
    • Promoted
    Family Medicine

    Family Medicine

    The Cigna GroupPeoria, Arizona, US
    Full-time
    Family Medicine physician employment in Arizona : .MEDICAL DIRECTOR - North West Region (Sun City / Sun City West / Paseo / Arrowhead) SIGN ON BONUS!. This position combines clinical practice of primary ca...Show moreLast updated: 22 days ago
    • Promoted
    Internal Medicine

    Internal Medicine

    The Inline GroupLitchfield Park, Arizona, US
    Full-time
    Internal Medicine physician employment in Arizona : The Inline Group -.Average Patients seen : Varies.Compensation : - Base Salary + RVU + Quality Incentives + Long Term Incentive Plan.Benefits : -...Show moreLast updated: 12 days ago
    • Promoted
    Senior Medical Director - Psychiatrist - Remote Based

    Senior Medical Director - Psychiatrist - Remote Based

    Syneos Health / inVentiv Health Commercial LLCPhoenix, 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 moreLast updated: 29 days ago
    • Promoted
    Medical Director

    Medical Director

    Stetson Hills Animal HospitalGlendale, AZ, US
    Full-time
    Medical Director - Stetson Hills Animal Hospital (Glendale, AZ) Schedule : • • 3 days a week • •.At Stetson Hills Animal Hospital in Glendale, Arizona, we are dedicated to providing exceptional veterin...Show moreLast updated: 6 days ago
    • Promoted
    Nursing Director Med Surg Telemetry

    Nursing Director Med Surg Telemetry

    Abrazo West CampusGOODYEAR, Arizona, United States
    Full-time
    Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Abrazo West Campus hospital, were seeking an innovative and experienced healthcare ...Show moreLast updated: 5 days ago
    • Promoted
    Family Medicine

    Family Medicine

    Enterprise Medical RecruitingPhoenix, Arizona, US
    Full-time
    Family Medicine physician job in Arizona : .The largest independent multi-specialty group in the Phoenix, Arizona, area is adding additional Family Medicine Physicians due to growth and retirements....Show moreLast updated: 22 days ago
    • Promoted
    Internal Medicine

    Internal Medicine

    The Cigna GroupPeoria, Arizona, US
    Full-time
    Internal Medicine physician employment in Arizona : .MEDICAL DIRECTOR - North West Region (Sun City / Sun City West / Paseo / Arrowhead) SIGN ON BONUS!. This position combines clinical practice of primary ...Show moreLast updated: 30+ days ago
    • Promoted
    Family Medicine

    Family Medicine

    CompHealthSun City, Arizona, US
    Full-time
    Family Medicine physician employment in Arizona : You will enjoy living and working in this suburb of Phoenix Arizona.The area has plenty of entertainment opportunities including professional sport...Show moreLast updated: 22 days ago
    • Promoted
    Family Medicine

    Family Medicine

    The Inline GroupGlendale, Arizona, US
    Full-time
    Family Medicine physician job in Arizona : The Inline Group -.Average Patients seen : Varies.Compensation : - Base Salary + RVU + Quality Incentives + Long Term Incentive Plan.Benefits : - Paid Tim...Show moreLast updated: 22 days ago