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