Remote Radiation Oncology Medical Director

Preferred Healthcare Staffing; Chanute (KS); Remote; USD 249,000 - 373,000; Full time

Benefits offered by this job

Work at home

Job summary

UnitedHealth Group is seeking an experienced Appeals M.D. for Radiation Oncology, remote within the U.S. The role involves reviewing appeals, regulatory responses, and collaborating with medical directors and network staff to address access, coverage, and quality issues.

The position requires an MD/DO license, board certification, 5+ years of clinical practice, and 2+ years in quality management, with strong communication and project management skills. Telework is allowed; travel is not required.

Qualifications

• MD or DO with an active, unrestricted license.
• Board Certified in an ABMS or AOBMS specialty.
• 5+ years of clinical practice experience.
• 2+ years of Quality Management experience.
• Familiarity with current medical issues and practices.
• Intermediate or higher level of proficiency with managed care.
• Proven excellent telephonic communication skills.
• Proven excellent project management skills.
• Proven data analysis and interpretation skills.
• Proven excellent presentation skills for both clinical and non‑clinical audiences.
• Proven creative problem‑solving skills.
• Proven basic computer skills, typing, word processing, presentation, and spreadsheet applications skills.
• Proven solid team player and team building skills.

Responsibilities

• + Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies
• + Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses
• + Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations
• + Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues
• + Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results
• + Provide clinical and strategic input when participating in organizational committees, projects, and task forces

Skills

MD/DO license

Board Certified

Clinical practice

Quality management

Telephonic communication

Project management

Data analysis

Presentation skills

Problem solving

Computer skills

Team player

Education

MD or DO degree

Job description

UnitedHealth Group is seeking an experienced Appeals M.D. for Radiation Oncology, remote within the U.S. The role involves reviewing appeals, regulatory responses, and collaborating with medical directors and network staff to address access, coverage, and quality issues.

The position requires an MD/DO license, board certification, 5+ years of clinical practice, and 2+ years in quality management, with strong communication and project management skills. Telework is allowed; travel is not required.