Medical Director, Utilization Review - Draper, UT or Telecommute
Company: UnitedHealth Group
Location: Draper
Posted on: March 20, 2023
Job Description:
Optum-combine two of the fastest-growing fields on the planet
with a culture of performance, collaboration and opportunity and
this is what you get. Leading edge technology in an industry that's
improving the lives of millions. Here, innovation isn't about
another gadget, it's about making health care data available
wherever and whenever people need it, safely and reliably. There's
no room for error. Join us and start doing your life's best work.
OptumCare is seeking aMedical Directorto join our Utilization
Review Team in Utah/Idaho. You will have the opportunity to drive
measureable and meaningful improvement in the use of evidence-based
medicine, patient safety, practice variation and affordability. You
can make a difference in serving our Medicare, Medicaid, and
commercial members and plan sponsors. Be part of changing the way
healthcare is delivered while working with a Fortune 6 industry
leader. You'll enjoy the flexibility to telecommute* from anywhere
within the U.S. 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
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 Medical License
- Current Board Certification in ABMS or AOA specialty
- 5+ years of clinical practice experience post residency
- Strong understanding of and concurrence with evidence-based
medicine (EBM) and managed care principles
- Full COVID-19 vaccination is an essential job function of this
role. Candidates located in states that mandate COVID-19 booster
doses must also comply with those state requirements. UnitedHealth
Group will adhere to all federal, state and local regulations as
well as all client requirements and will obtain necessary proof of
vaccination, and boosters when applicable, prior to employment to
ensure compliance. Candidates must be able to perform all essential
job functions with or without reasonable accommodation To protect
the health and safety of our workforce, patients and communities we
serve, UnitedHealth Group and its affiliate companies require all
employees to disclose COVID-19 vaccination status prior to
beginning employment. In addition, some roles and locations require
full COVID-19 vaccination, including boosters, as an essential job
function. UnitedHealth Group adheres to all federal, state and
local COVID-19 vaccination regulations as well as all client
COVID-19 vaccination requirements and will obtain the necessary
information from candidates prior to employment to ensure
compliance. Candidates must be able to perform all essential job
functions with or without reasonable accommodation. Failure to meet
the vaccination requirement may result in rescission of an
employment offer or termination of employment 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 Telecommuters will be required to adhere to UnitedHealth
Group's Telecommuter Policy. About OptumCare: At OptumCare, we've
found that putting clinicians at the center of care is the best way
to improve lives. Our physician-led organization is one of the most
dynamic and progressive health care organizations in the world,
serving over 17 million people through more than 45,000 aligned
physicians and 9,000 advanced practice clinicians. You will find
our team working in local clinics, surgery centers and urgent care
centers, within care models focused on managing risk, higher
quality outcomes and driving change through collaboration and
innovation. Learn more at . Would you thrive with OptumCare?
- Do you practice evidence-based medicine?
- Are you seeking a practice focused on patient-centered quality
care, not volume?
- Are you a team player - comfortable delegating and empowering
teams?
- Are you constantly seeking better ways to do things?
- Do you want to be part of something better? Diversity creates a
healthier atmosphere: OptumCare is an Equal Employment
Opportunity/Affirmative Action employers and all qualified
applicants will receive consideration for employment without regard
to race, color, religion, sex, age, national origin, protected
veteran status, disability status, sexual orientation, gender
identity or expression, marital status, genetic information, or any
other characteristic protected by law. OptumCare is a drug-free
workplace. Candidates are required to pass a drug test before
beginning employment.
Keywords: UnitedHealth Group, Draper , Medical Director, Utilization Review - Draper, UT or Telecommute, Executive , Draper, Utah
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