National Senior Medical Director - Remote

UnitedHealth Group; Minneapolis (MN); Remote; Confidential; Full time

Job summary

An established industry player is seeking a National Senior Medical Director to lead innovative clinical programs. This role involves strategic oversight of clinical documentation review and DRG coding, ensuring effective implementation and collaboration across teams. The successful candidate will engage with executives and frontline providers, fostering a culture of continuous improvement. Enjoy the flexibility of remote work while making a significant impact on health equity and patient outcomes. Join a mission-driven organization dedicated to improving lives and advancing health care for all.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Qualifications

• 5+ years of management experience with clinical documentation expertise.
• Strong background in DRG coding and clinical operations.

Responsibilities

• Lead the DRG Clinical Review program and team of medical directors.
• Drive value in existing workstreams and expand portfolio of solutions.

Skills

Clinical Documentation Review

DRG Coding

Data Analysis

Leadership

Collaboration

Education

M.D. or D.O. degree

Board certification in a recognized specialty

MBA, MMM, MPH or similar master’s level degree

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Clinical Excellence, a national OptumCare team, is currently seeking an experienced National Senior Medical Director to join our growing Value Innovations efforts. This key executive Physician will provide expertise and leadership on population, specifically Clinical Documentation Review with expertise in application of DRG coding and clinical operations. This position leads the strategy, design and implementation of existing and future value-based initiatives and programs.

At Clinical Excellence, our mission is effective implementation, monitoring, & execution of clinical programs that improve the patient & provider experience, while delivering superior outcomes at a sustainable cost. We aim to achieve repeatable, practical, sustainable, & compliant solutions that deliver value to the OptumCare businesses. We serve as national support for our internal physician groups in achieving clinical improvement or capability-building initiatives.

This executive physician will be comfortable interacting daily with executives, as well as frontline providers and operational staff. The successful candidate will be able to not only drive value in existing workstreams, but to build and expand our portfolio of solutions in other domains. Leadership responsibilities include representing the programs under their leadership in senior executive meetings, leading reviews and improvements of clinical programs and processes, and being a financial steward in areas of responsibility.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Lead Optum Enterprise Innovative DRG Clinical Review program
• Assume leadership Optum DRG Optimization Programs
• Lead a team of medical directors, nurse coders and operations team to deliver DRG Clinical Review performance
• Identifying opportunities to expand and optimize program success in collaboration with other programs, such as hospital utilization management and claims adjudication teams
• Collaborate with IT partners to implement AI enhancements within program
• Participate in other Value Innovation programs, as assigned
• Change Management
• Participate in the cross collaboration with regional care delivery organizations through OH and Payment Integrity
• Closely partner with IT on development and implementation of program delivery
• Emotional Maturity and EQ
• Establishing strong and lasting, trust-based relationships within team and external partners
• Foster exemplary teamwork and strengthen a culture of continuous improvement and accountability
• Take initiative and self-start attitude to approach problems with energy and passion
• Demonstrate preference for working in a tight-knit team environment with diverse professional groups

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:

• M.D. or D.O. degree
• Board certified in a recognized specialty
• 5+ years of experience in a management role
• 3+ years of clinical experience post residency
• Experience with DRG clinical documentation and/or coding team collaboration within a hospital system or payor
• Experience with data analysis, synthesis and presentation experience to both internal and external keyholders

Preferred Qualification:

• MBA, MMM, MPH or similar master’s level degree

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

The salary range for this role is $343,500 to $516,500 annually based on full-time employment. Salary Range is defined as total cash compensation at target. The actual 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 local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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