National Senior Medical Director - Remote

Lensa; Philadelphia (Philadelphia County); Remote; USD 278,000 - 418,000; Full time

Job summary

Lensa is seeking a National Senior Medical Director for a remote role with UnitedHealth Group. The successful candidate will lead clinical initiatives, focusing on DRG coding and documentation, while ensuring optimal health outcomes. This position offers a competitive salary and comprehensive benefits in a diverse and inclusive environment.

Benefits

Comprehensive health plans

Incentive programs

Stock options

401(k)

Qualifications

• 5+ years of management experience.
• 3+ years of clinical experience post-residency.
• Experience with DRG clinical documentation and coding.

Responsibilities

• Lead Optum Enterprise Innovative DRG Clinical Review program.
• Collaborate with IT partners to implement AI enhancements.
• Foster teamwork and a culture of continuous improvement.

Skills

Leadership

Clinical Documentation Review

Data Analysis

Collaboration

Change Management

Education

M.D. or D.O. degree

Board certification in a recognized specialty

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

Job description

National Senior Medical Director - Remote

2 days ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, UnitedHealth Group, is seeking professionals. Apply via Lensa today!

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 health, specifically Clinical Documentation Review with expertise in 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 the effective implementation, monitoring, and execution of clinical programs that improve the patient and provider experience, while delivering superior outcomes at a sustainable cost. We aim to achieve repeatable, practical, sustainable, and 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, frontline providers, and operational staff. The successful candidate will be able to drive value in existing workstreams 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 of Optum DRG Optimization Programs
• Lead a team of medical directors, nurse coders, and operations teams to deliver DRG Clinical Review performance
• Identify 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 the program
• Participate in other Value Innovation programs, as assigned
• Change Management
• Collaborate with regional care delivery organizations through OH and Payment Integrity
• Partner closely with IT on development and implementation of program delivery
• Demonstrate emotional maturity and EQ
• Establish strong, trust-based relationships within the team and external partners
• Foster teamwork and a culture of continuous improvement and accountability
• Take initiative and approach problems with energy and passion
• Work effectively in a diverse, tight-knit team environment

We offer a challenging environment with clear success metrics and development opportunities for your career growth.

Required Qualifications

• M.D. or D.O. degree
• Board certification in a recognized specialty
• 5+ years of management experience
• 3+ years of clinical experience post-residency
• Experience with DRG clinical documentation and coding within hospital systems or payors
• Experience with data analysis, synthesis, and presentation to key stakeholders

Preferred Qualifications

• MBA, MMM, MPH, or similar master’s degree
• Adherence to UnitedHealth Group’s Telecommuter Policy for remote employees

The salary range for this role is $278,000 to $417,500 annually, based on experience and performance. Benefits include comprehensive health plans, incentive programs, stock options, and 401(k).

Application Deadline: Minimum of 2 business days or until a sufficient candidate pool is reached.

Our mission is to help people live healthier lives and address health disparities, ensuring equitable care for all.

UnitedHealth Group is an Equal Opportunity Employer and a drug-free workplace, requiring pre-employment drug testing.