Medical Director - Otolaryngology - Remote

Lensa; Indianapolis (IN); Remote; USD 238,000 - 358,000; Full time

Job summary

A leading career site is seeking a Medical Director in Otolaryngology for a remote role. This position involves clinical reviews, collaboration with healthcare teams, and ensuring quality care delivery. Candidates must hold an M.D. or D.O. and have board certification in Otolaryngology, with a strong emphasis on communication and problem-solving skills.

Benefits

Comprehensive benefits packages

Incentive programs

Stock purchase options

401(k)

Qualifications

• 5+ years of clinical practice post-residency.
• Active, unrestricted medical license required.
• Ability to participate in call rotations.

Responsibilities

• Conduct coverage reviews based on member benefits and policies.
• Document findings and engage with providers in discussions.
• Communicate with internal teams to ensure accurate benefit determinations.

Skills

Evidence-Based Medicine

Communication

Problem-Solving

Data Analysis

Education

M.D. or D.O.

Board certification in Otolaryngology

Tools

MS Word

Outlook

Excel

Job description

Medical Director - Otolaryngology - Remote

Be among the first 25 applicants

Lensa, the leading career site for job seekers at every career stage, is partnering with UnitedHealth Group, seeking qualified professionals. Apply today via Lensa!

Optum, a global organization, delivers care enhanced by technology to help millions live healthier lives. Your work will directly impact health outcomes by connecting people with necessary care, pharmacy benefits, data, and resources. We foster a culture rooted in diversity and inclusion, supported by talented peers, comprehensive benefits, and career development opportunities. Join us to make a meaningful impact on communities and advance health equity globally. Together, we are Caring. Connecting. Growing.

Our Clinical Advocacy & Support team focuses on exceeding expectations through clinical coverage and medical claims reviews. We empower providers and members with tools and information to improve health outcomes, reduce care variation, ensure seamless experiences, and manage healthcare costs.

The Medical Director supports Enterprise Clinical Services operations, overseeing initial clinical reviews of service requests. The role involves collaboration with leadership and staff to establish, support, and maintain processes related to benefit coverage determinations, quality improvement, and cost-effective services. The focus is on clinical knowledge application in utilization management, particularly pre-service benefit and coverage determinations or medical necessity, and communicating these processes with network and non-network physicians.

The Medical Director works with a multidisciplinary team, managing medical benefits often involving primary care or specialist physicians, ensuring delivery of appropriate, cost-effective, high-quality care.

This remote role offers flexibility to work from anywhere within the U.S.

Primary Responsibilities

1. Conduct coverage reviews based on member benefits and policies, rendering determinations.
2. Document findings, actions, and outcomes per policies and regulations.
3. Engage with providers in peer-to-peer discussions as needed.
4. Interpret benefit language and policies during reviews.
5. Participate in daily clinical rounds if requested.
6. Communicate and collaborate with providers and internal teams to ensure accurate benefit determinations and educate on plans and policies.
7. Handle call coverage rotations.

Required Qualifications

• M.D. or D.O.
• Board certification in Otolaryngology (ENT)
• Active, unrestricted medical license
• 5+ years of clinical practice post-residency
• Understanding of Evidence-Based Medicine (EBM)
• Proficiency in MS Word, Outlook, Excel
• Ability to participate in call rotations

Preferred Qualifications

• Experience in utilization and coverage review
• Excellent communication and facilitation skills
• Data analysis and interpretation skills
• Innovative problem-solving abilities
• Ability to communicate effectively with clinical and non-clinical audiences
• Residency in MST or PST zones or willingness to work those hours
• Adherence to UnitedHealth Group’s Telecommuter Policy for remote employees

The salary range is $238,000 to $357,500 annually, based on full-time employment, experience, and metrics. Benefits include comprehensive packages, incentive programs, stock purchase options, and 401(k). The application deadline is at least 2 business days from posting or until a sufficient candidate pool is reached.

UnitedHealth Group is committed to diversity, equity, and inclusion, addressing health disparities and promoting equitable care. We are an Equal Opportunity Employer and a drug-free workplace, requiring a pre-employment drug test.