Associate Medical Director – UnitedHealthcare Community & State (New York)

UnitedHealth Group•New York, NY

5d•$248,500 - $373,000•Remote

About The Position

The Associate Medical Director for UnitedHealthcare Community & State New York is a clinical leadership role focused on improving quality, supporting thoughtful medical decision-making, and enhancing the member and provider experience across Medicaid, D-SNP, and long-term care populations. Working closely with the Chief Medical Officer and cross-functional partners, the role helps shape utilization management, quality improvement, provider collaboration, and population health efforts while ensuring alignment with New York Department of Health requirements and applicable state and federal regulations. The position provides clinical leadership for utilization management, prior authorization, appeals and grievances, provider quality activities, clinical rounds, peer review, and interdisciplinary rounds. It supports evidence-based coverage decisions, standardized clinical approaches, provider education and engagement, and implementation of policy and process changes. The role also contributes clinical insight to care management, population health, quality initiatives, strategic planning, and program development, and supports colleagues through mentoring and collaborative leadership. This is a New York-based role with remote flexibility. Occasional in-state travel may be required, and remote employees must follow UnitedHealth Group’s Telecommuter Policy. Compensation generally ranges from $248,500 to $373,000 in total cash compensation, including base pay and bonus. The posting also mentions a comprehensive benefits package, incentive and recognition programs, an equity stock purchase plan, and a 401(k) contribution, subject to eligibility requirements.

Requirements

MD or DO with an active, unrestricted New York medical license.
Active and unrestricted board certification in an ABMS or AOBMS specialty.
At least 5 years of post-residency clinical practice experience with solid clinical judgment.

Nice To Haves

Experience in managed care, utilization management, and/or appeals and grievances.
Experience supporting Medicaid, D-SNP, and/or LTC populations in a health plan, managed care, or value-based care setting.
Knowledge of quality improvement, population health, and applicable regulatory requirements.
Experience building provider relationships and collaborating across teams in a matrixed environment.
Strong communication skills and ability to work effectively across clinical, operational, and provider-facing teams.

Responsibilities

Provide clinical leadership for utilization management, prior authorization, appeals and grievances, and provider quality activities across New York Medicaid, LTC, and D-SNP populations.
Support timely, evidence-based coverage decisions aligned with clinical guidelines, plan policies, and regulatory expectations.
Partner with United Clinical Services and enterprise teams to support regulatory changes and strengthen clinical operations.
Participate in clinical rounds and advise on adult and pediatric cases.
Identify care gaps and advance evidence-based interventions to improve clinical quality and member outcomes.
Participate in peer review activities, including Quality of Care and Quality of Service evaluations.
Provide clinical leadership during interdisciplinary rounds and support evidence-based standards of care.
Promote evidence-based practice and standardized clinical approaches that support high-quality care.
Engage network providers to address care gaps, support quality improvement, and encourage evidence-based practice.
Identify performance improvement opportunities based on new clinical evidence, trend review, and New York State program opportunities.
Apply knowledge of AHCA requirements and applicable state and federal Medicaid regulations to support compliant clinical operations.
Support implementation of policy and process changes that enhance clinical programs and operations.
Help reduce unwarranted variation in care through provider education, engagement, and best practices.
Partner with the Chief Medical Officer and plan leadership to advance clinical strategies aligned with market, regulatory, and organizational priorities.
Support development and execution of care models that improve outcomes and member experience.
Mentor and support clinical and operational colleagues to encourage growth, collaboration, and strong performance.
Help foster a culture of accountability, collaboration, and continuous improvement.
Bring clinical insight into care management, population health, and quality improvement initiatives.
Contribute to strategic planning, program development, and operational priorities.