Utilization Management Medical Director, Clinical Performance

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 * as you take on some tough challenges.

Primary 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
  

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.

Required Qualifications:

• MD or DO degree
  
• Active, unrestricted California state license 
  
• Current board certification in ABMS or AOA specialty
  
• 5+ years of clinical practice experience post residency
  
• Solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles
  

Preferred Qualifications:

• Hands-on utilization and/or quality management experience
  
• Project management or active project participation experience
  
• Substantial experience in using electronic clinical systems
  

*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 annually based on full-time employment. 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.