Sr. Medical Director of Medical Management – Telecommute

UnitedHealth Group
Published
June 6, 2021
Location
Atlanta, GA
Category
Job Type

Description

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 is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

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 7 industry leader.

You’ll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.

Primary Responsibilities:

  • Program development including:
    • Workflow development 
      • Driving efficiency
      • Outcomes and improved results 
      • Standardization of process 
    • Ensuring regulatory adherence (primarily Medicare Advantage)
    • Relationship building within operations and with CDO contacts
    • Primary liaison between payor / local market (CDO) and clinical decision making (UM) teams for E2E processes 
    • Participation in pre-delegation audits, annual audits as needed 
  • Function as clinical leader SME with payors and as needed regulators (when appropriate for Risk bearing entity audits (RBE) r/t UM and DM
  • Function as identified clinical leader (MD) for Optum care Clinical Performance Medical management processes 
  • Clinical liaison with Care Delivery Organizations for end to end medical management capabilities
  • Full functional knowledge of CMS, NCQA and URAC UM and population health requirements 
  • Demonstrates and role models how to work effectively in a fully matrixed organization
  • Thought leader to validate technology tools and capabilities that support medical management processes 

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 physician state license
  • Current board certification in ABMS or AOA specialty
  • 5+ years of clinical practice experience post residency
  • 5+ years of experience managing a team of providers
  • 5+ years of experience working within a Risk Adjustment Model of Care
  • Solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

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

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 7, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Colorado Residents Only: The salary range for Colorado residents is $293,200 to $324,800. The 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 education, work experience, certifications, etc. 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.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Senior Medical Director, Medical Director, Medical Management, MD, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote

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