Remote Orthopedic Spine Surgeon, Medical Director

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 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.