Remote Physician Medical Director, DME - Clinical Oversight

Optum; Houston (TX); Remote; USD 238,000 - 358,000; Full time

Benefits offered by this job

Remote work

Comprehensive benefits

Equity stock purchase

401k contribution

Job summary

Optum in the United States is seeking a Physician Medical Director DME to lead clinical reviews and benefit determinations remotely. The role requires MD or DO, an active license, and board certification in PM&R, Internal Medicine, or Family Medicine.

You'll support Enterprise Clinical Services and collaborate with network and non-network physicians to ensure cost-effective, high-quality care. You can work remotely from anywhere in the U.S.; compensation ranges from $238,000 to $357,500 plus

Qualifications

• MD or DO with active, unrestricted license.
• Board certification in PM&R, Internal Medicine, or Family Medicine.
• 5+ years of clinical practice after residency.
• Strong knowledge of Evidence-Based Medicine.
• Proficient MS Word, Outlook and Excel.

Responsibilities

• Conduct coverage reviews and render determinations.
• Document findings per policies and regulatory requirements.
• Engage in peer discussions with providers.
• Interpret benefit language for clinical reviews.
• Participate in daily clinical rounds.
• Collaborate with network and non-network providers to determine benefits.

Skills

MD/DO

Medical license

Board-certified

Clinical practice

MS Word

Outlook

Excel

Evidence-Based Medicine

Education

MD/DO degree

Tools

MS Word

Outlook

Excel

Job description

Optum in the United States is seeking a Physician Medical Director DME to lead clinical reviews and benefit determinations remotely. The role requires MD or DO, an active license, and board certification in PM&R, Internal Medicine, or Family Medicine.

You'll support Enterprise Clinical Services and collaborate with network and non-network physicians to ensure cost-effective, high-quality care. You can work remotely from anywhere in the U.S.; compensation ranges from $238,000 to $357,500 plus