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Medical Director
hace 1 mes
UnitedHealth Group is seeking a highly skilled Medical Director to lead our Enterprise Clinical Services operations. As a key member of our clinical leadership team, you will be responsible for providing physician support and collaborating with leadership and staff to establish, implement, and maintain clinical and operational processes.
Key Responsibilities- Conduct coverage reviews and render determinations based on individual member plan benefits and national and proprietary coverage review policies
- Document clinical review findings, actions, and outcomes in accordance with policies and regulatory requirements
- Engage with requesting providers in peer-to-peer discussions and communicate with network and non-network providers to ensure accurate and timely benefit determinations
- Participate in daily clinical rounds and collaborate with internal partners to achieve optimal health outcomes
- M.D. or D.O. degree
- Active unrestricted license to practice medicine
- Board certification in an ABMS specialty
- 3+ years of clinical practice experience after completing residency training
- Solid understanding of Evidence-Based Medicine (EBM) and proficiency in MS Word, Outlook, and Excel
- Experience in utilization and clinical coverage review
- Proven data analysis and interpretation aptitude
- Proven innovative problem-solving skills and excellent presentation skills for clinical and non-clinical audiences
UnitedHealth Group offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. We are an equal employment opportunity/affirmative action employer and welcome candidates from diverse backgrounds.
