Remote Medical Director, Vascular Care & Utilization

Women's Vascular Summit; Boston (MA); Remote; USD 249,000 - 373,000; Full time

Job summary

UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on pre-service benefit determinations and medical necessity. You will collaborate with leadership to improve processes and ensure cost-effective, high-quality care for members.

The role offers remote work across the U.S. with opportunities for professional development and cross-functional collaboration across disciplines.

Qualifications

• M.D or D.O.
• Board certification in General Surgery with vascular experience
• Active unrestricted license to practice medicine
• 5+ years of clinical practice after residency
• Sound understanding of Evidence Based Medicine (EBM)
• Experience performing vascular surgeries and procedures
• MS Word, Outlook and Excel proficiency
• Willingness to participate in call coverage rotation

Responsibilities

• Conduct coverage reviews based on member plan benefits and policies
• Render coverage determinations and document findings
• Engage with requesting providers in peer-to-peer discussions
• Interpret benefit language and policies for reviews
• Participate in daily clinical rounds as requested
• Collaborate with network and non-network providers for accurate determinations
• Coordinate with internal partners
• Support rotation of coverage calls

Skills

Vascular surgery

EBM

Clinical leadership

Call coverage

Regulatory knowledge

Education

MD or DO

Tools

MS Word

Outlook

Excel

Job description

UnitedHealth Group is seeking a Medical Director to provide physician support for Enterprise Clinical Services, focusing on pre-service benefit determinations and medical necessity. You will collaborate with leadership to improve processes and ensure cost-effective, high-quality care for members.

The role offers remote work across the U.S. with opportunities for professional development and cross-functional collaboration across disciplines.