Medical Director - Orthopaedic Surgery - Remote

Lensa; Philadelphia (Philadelphia County); Remote; USD 238,000 - 358,000; Full time

Job summary

A leading career site is seeking a Medical Director in Orthopaedic Surgery to join UnitedHealth Group's team remotely. The role involves overseeing medical review services, conducting coverage reviews, and developing clinical policies. Candidates must hold an MD or DO with Board Certification and have extensive clinical experience. The position offers a competitive salary and emphasizes diversity and health equity.

Benefits

Comprehensive healthcare

Incentives

Stock purchase options

401k plan

Qualifications

• At least 5 years of clinical practice post-residency.
• Proficiency in MS Office and computer skills.

Responsibilities

• Conduct coverage reviews for musculoskeletal surgical procedures.
• Document clinical findings adhering to policies and standards.
• Engage in peer-to-peer discussions with providers.

Skills

Interpersonal skills

Telecommunication skills

Understanding of Evidence-Based Medicine

Education

MD or DO with active, unrestricted license

Board Certification in Orthopaedic Surgery

Tools

MS Office

Job description

Medical Director - Orthopaedic Surgery - Remote

Lensa is the leading career site for job seekers at every stage of their career. Our client, UnitedHealth Group, is seeking a Medical Director in Orthopaedic Surgery to join their team remotely within the U.S.

The Medical Director will oversee the quality and coordination of medical review services, perform Utilization Management reviews, and participate in Quality Improvement programs. The role involves developing policies, procedures, and clinical criteria for medical programs, and liaising with physicians and medical providers.

Primary Responsibilities:

1. Conduct coverage reviews for musculoskeletal surgical procedures and related services.
2. Document clinical findings, actions, and outcomes adhering to policies and regulatory standards.
3. Coordinate coverage reviews with clinical staff and provide feedback.
4. Engage in peer-to-peer discussions with providers as needed.
5. Interpret benefit language and policies during reviews.
6. Participate in clinical conferences and internal performance reviews.
7. Collaborate with providers and internal partners to ensure accurate benefit determinations.
8. Provide periodic coverage rotation and be available for weekend and holiday coverage as needed.
9. Participate in training on compliance, confidentiality, HIPAA, and related topics.
10. Monitor professional performance and engage with providers accordingly.

Required Qualifications:

• MD or DO with active, unrestricted license and Board Certification in Orthopaedic Surgery.
• At least 5 years of clinical practice post-residency.
• Understanding of Evidence-Based Medicine.
• Proficiency in MS Office and computer skills.
• Excellent interpersonal and telecommunication skills.

Preferred Qualifications:

• 2+ years in managed care, Quality Management, or administrative leadership.
• Experience in utilization and clinical coverage review.
• Recent clinical experience within the past 2 years.

The role offers a salary range of $238,000 to $357,500 per year, with benefits including comprehensive healthcare, incentives, stock purchase options, and a 401k plan. The position emphasizes diversity, inclusion, and health equity, aligning with UnitedHealth Group's mission to improve health outcomes and reduce disparities.