Remote Medical Director – Sleep Medicine & Coverage

NHSHP; Minneapolis (MN); Hybrid; USD 249,000 - 373,000; Full time

Benefits offered by this job

Remote work from anywhere in the U.S.

Comprehensive benefits

Career development opportunities

Job summary

UnitedHealth Group's Optum division is seeking a Medical Director to provide physician support to Enterprise Clinical Services, overseeing clinical coverage determinations and medical necessity reviews. You will collaborate with leadership and network/non-network physicians to ensure cost-effective, high-quality care and compliant processes.

You’ll work remotely from anywhere in the U.S., participate in peer discussions and clinical rounds, and guide utilization management while maintaining an

Qualifications

• MD or DO
• Board certification in Sleep Medicine
• Active unrestricted license to practice medicine
• 5+ years of clinical practice after completing residency training
• Proven sound understanding of Evidence Based Medicine (EBM)
• Proven solid PC skills, specifically using MS Word, Outlook, and Excel

Responsibilities

• Conduct coverage reviews based on member plan benefits and policies
• Document clinical review findings and outcomes per policies and regulations
• Engage with requesting providers in peer-to-peer discussions
• Interpret benefit language and policies during clinical reviews
• Participate in daily clinical rounds as requested
• Communicate with network and non-network providers to ensure timely determinations
• Collaborate with internal partners
• Participate in holiday and call coverage rotation

Skills

5+ years of clinical practice

Evidence Based Medicine (EBM)

MS Word/Outlook/Excel

Education

MD or DO

Board certification in Sleep Medicine

Active unrestricted medical license

Job description

UnitedHealth Group's Optum division is seeking a Medical Director to provide physician support to Enterprise Clinical Services, overseeing clinical coverage determinations and medical necessity reviews. You will collaborate with leadership and network/non-network physicians to ensure cost-effective, high-quality care and compliant processes.

You’ll work remotely from anywhere in the U.S., participate in peer discussions and clinical rounds, and guide utilization management while maintaining an