Orthopedic Spine Surgery, Medical Director - Work from home!

Optum; Cincinnati (OH); Remote; USD 248,000 - 373,000; Full time

Benefits offered by this job

Remote work

Weekdays schedule

Benefits package

Job summary

Optum is hiring an Orthopedic Spine Surgeon to join the Focus Claims Review team. The Medical Director will participate in all aspects of claim review services, including discussions with providers and appeals, and may assist with coding procedures development.

The role emphasizes remote work flexibility within the U.S., a Monday–Friday schedule with flexible hours, and a comprehensive onboarding and benefits package to support care decisions and outcomes.

Qualifications

• MD or DO degree required.
• Board certification in Orthopedic Surgery required.
• Active, unrestricted medical license in any U.S. state.
• Minimum of 5 years of clinical practice post-residency, spine preferred.

Responsibilities

• Review surgical & spinal claims for correct coding using clinical records.
• Perform coverage reviews based on member plan benefits.
• Collaborate with treating providers via peer-to-peer outreach.
• Apply evidence-based guidelines (e.g., InterQual) to support care decisions.
• Partner with internal teams on clinical and quality initiatives.

Skills

Clinical spine expertise

Peer-to-peer collaboration

Evidence-based decision making

Education

MD or DO degree

Board certification in Orthopedic Surgery

Active medical license in US

5+ years post-residency experience

Job description

Optum | A culture of Caring. Connecting. Growing together.

Optum is hiring an Orthopedic Spine Surgeon to be a part of the Focus Claims Review team. The Medical Director will participate in all aspects of claim review services including provider telephonic discussions and provider appeals. In addition, the Medical Director may also be asked to assist in the direction and oversight in the development and implementation of coding and procedures.

Your Impact:

• Reviews surgical & spinal claims for correct coding using clinical record
• Conduct coverage reviews based on individual member plan benefits
• Collaborate with treating providers via peer-to-peer telephonic outreach
• Apply evidence-based guidelines (e.g., InterQual) to support care decisions
• Partner with internal teams on clinical and quality initiatives

What you bring:

• MD or DO degree
• Board certification in Orthopedic Surgery
• Active, unrestricted medical license in any U.S. state
• Minimum of 5 years of clinical practice experience post residency in Orthopedic surgery (preferably spine)

Why Join Optum?

• Remote Flexibility: Work from anywhere in the U.S.
• Consistent Schedule: Weekdays Monday - Friday (flexible 8 hr. shifts; no weekends)
• Strong Support: Comprehensive onboarding, training & ongoing guidance
• Purpose-Driven Team: Join a national network committed to better health outcomes

Compensation & Benefits

The salary range is $248,000-$373,000, which includes base pay and bonus. Total compensation is influenced by several factors. Eligibility for benefits varies by role and tenure.

In addition to salary, we offer a comprehensive benefits package that may include:

• Incentive and recognition programs
• Equity stock purchase options
• 401(k) contributions
• Health, wellness, and insurance benefits

Pre-Employment Screening

Optum is a drug-free workplace. Candidates must pass a drug test before beginning employment.

Our Commitment

Optum is committed to delivering equitable care and improving health outcomes for all. We are proud to be an Equal Employment Opportunity employer.