Medical Director - Neurosurgery - Remote

Lensa; Nashville (TN); Remote; USD 238,000 - 358,000; Full time

Job summary

A leading healthcare company is seeking a Medical Director specialized in Neurosurgery for a remote role. The position involves overseeing claims review processes, collaborating with providers, and ensuring compliance with medical standards. Candidates must have an MD or DO, board certification, and significant clinical experience in Neurosurgery. The role offers a competitive salary range and comprehensive benefits, along with flexibility to work remotely.

Benefits

Comprehensive health plans

Incentive programs

Stock options

401k

Qualifications

• At least 5 years of clinical experience in Neurosurgery, including spinal surgery.

Responsibilities

• Review surgical and professional claims for correct coding using clinical records.
• Draft clinical summaries and rationales for medical necessity decisions.

Skills

Leadership

Interpersonal Skills

Telecommunication Skills

Education

MD or DO

Board certification in Neurosurgery

Tools

MS Office

Job description

Medical Director - Neurosurgery - Remote

We are seeking a qualified Medical Director specialized in Neurosurgery for a remote position. The role involves providing leadership and oversight for the claims review program within the Focus Claims Review team at Optum, part of UnitedHealth Group. The Medical Director will ensure quality and effectiveness of medical services, participate in provider discussions, and help develop policies and clinical criteria. This position requires collaboration with physicians and medical providers, adherence to regulatory standards, and occasional travel within the US.

Primary Responsibilities

• Review surgical and professional claims for correct coding using clinical records
• Participate in training on URAC, NCQA, HIPAA, and other compliance standards
• Discuss cases and clinical coding with providers telephonically
• Contribute to clinical conferences and performance reviews
• Draft clinical summaries and rationales for medical necessity decisions
• Provide support for clinical staff reviews and performance measurement discussions

Minimum Qualifications

• MD or DO with an active, unrestricted medical license
• Board certification in Neurosurgery
• At least 5 years of clinical experience in Neurosurgery, including spinal surgery
• Proficiency in MS Office applications

Preferred Qualifications

• Experience in managed care and claim coding reviews
• Knowledge of clinical and financial data integration and reporting
• Excellent interpersonal and telecommunication skills

Additional Details

The salary range is $238,000 to $357,500 annually, with benefits including comprehensive health plans, incentive programs, stock options, and 401k. The role offers flexibility to work remotely from anywhere in the US, with occasional travel required. UnitedHealth Group is committed to diversity, equity, and inclusion, and is an equal opportunity employer. Candidates must pass a drug test before employment.