UM Medical Director - Radiation Oncology Physician - Remote
About The Position
The Radiation Oncology Medical Director provides clinical leadership and specialty expertise in support of the Cancer Guidance Program within Enterprise Clinical Services. The role applies radiation oncology expertise to clinical coverage and medical necessity reviews to support high-quality, evidence-based, appropriate cancer care. Working with a multidisciplinary clinical team, the Medical Director reviews radiation oncology treatment requests, makes coverage determinations based on applicable benefits, clinical policies, and evidence-based criteria, and engages treating physicians in peer-to-peer discussions when needed. The role also contributes clinical expertise to the quality, consistency, and effectiveness of the Cancer Guidance Program. This is a remote position that may be performed from anywhere within the United States.
Requirements
- MD or DO degree.
- Active, unrestricted physician state license.
- Current board certification in Radiation Oncology.
- At least 5 years of clinical practice experience after residency.
- Solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles.
- Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.
- Candidates must pass a drug test before beginning employment.
Nice To Haves
- Hands-on utilization and/or quality management experience.
- Project management or active project participation experience.
- Substantial experience using electronic clinical systems.
Responsibilities
- Perform utilization review determinations for oncology populations and support case and disease management teams in achieving optimal clinical outcomes.
- Serve as a subject matter expert in evidence-based oncology guidelines, particularly National Comprehensive Cancer Network (NCCN) guidelines, and help ensure clinical policies and processes reflect the best available evidence.
- Engage and collaborate with treating providers by telephone to discuss evidence-based guidelines, opportunities to close clinical quality or service gaps, and care plan changes that may affect health care expense.
- Enhance the clinical expertise of the Oncology team through education sessions with nursing teams, and serve as a thought leader and point of contact for relevant medical societies and stakeholders.
- Evaluate clinical and other data, including quality metrics, claims and health record data, and utilization data, to identify opportunities to improve clinical care and processes.
- Collaborate with operational and business partners on enterprise-wide research and clinical and quality initiatives to enhance Optum’s impact in oncology.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase program.
- 401(k) contribution, subject to eligibility requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Ph.D. or professional degree
