Inpatient UM - Medical Director - Remote

UnitedHealth Group Inc.•Los Angeles, CA

48d•$238,000 - $357,500•Remote

About The Position

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 4 industry leader. We are currently seeking a Utilization Management Medical Director to join our Clinical Performance team. This team is responsible for conducting hospital and post-acute utilization reviews for the state of California. The Medical Directors work with groups of nurses and support staff to manage inpatient care utilization. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Success in this technology-heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production-driven setting. 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.

Requirements

MD or DO degree
Active, unrestricted medical license
Current board certification in ABMS or AOA specialty
5+ years of clinical practice experience post residency
Utilization Management experience for an insurance or managed care organization (both inpatient and post acute reviews)
Solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles

Nice To Haves

Quality management experience
Project management or active project participation experience
Substantial experience in using electronic clinical systems

Responsibilities

Work to improve quality and promote evidence-based medicine
Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement
Support initiatives that enhance quality throughout our national network
Ensure the right service is provided at the right time for each member
Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review