Remote Medical Director, Utilization Management

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

Benefits offered by this job

Remote work within US

Comprehensive benefits

Equity stock purchase

401k contribution

Job summary

UnitedHealth Group's Optum division seeks a Medical Director to provide physician support for Enterprise Clinical Services, shaping coverage determinations and cost-effective care. The role collaborates with clinicians to ensure appropriate medical review and policy adherence.

The position requires an MD or DO, board certification, an active unrestricted license, and 5+ years of clinical practice. Remote work is available nationwide in the United States, with ongoing clinical and operational

Qualifications

• MD or DO degree required.
• Current board certification through ABMS or AOA.
• Active, unrestricted medical license.

Responsibilities

• Conduct clinical coverage reviews based on member benefits and policies, render determinations.
• Document findings and outcomes per policies, regulations, and accreditation.
• Engage with providers in peer-to-peer discussions as needed.
• Interpret benefit language and policies during reviews for accuracy.
• Participate in daily clinical rounds as requested.
• Collaborate with network and non-network providers to educate on plans and policies.

Skills

EBM

MS Word

Outlook

Excel

Education

MD or DO degree

Board certification ABMS or AOA

Active unrestricted medical license

Job description

UnitedHealth Group's Optum division seeks a Medical Director to provide physician support for Enterprise Clinical Services, shaping coverage determinations and cost-effective care. The role collaborates with clinicians to ensure appropriate medical review and policy adherence.

The position requires an MD or DO, board certification, an active unrestricted license, and 5+ years of clinical practice. Remote work is available nationwide in the United States, with ongoing clinical and operational