Medical Management is focused on driving measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability. In serving our Medicare, Medicaid, and commercial members & plan sponsors, our Clinical Services teams partner with our network of physicians, hospitals and other health care professionals to achieve these goals. We are committed to our mission of helping people live healthier lives.
As a Medical Director in Medical Management, you will do your part by working to improve quality and promote evidence-based medicine. This includes using data and our ability to engage to help people improve their health and stay healthy. You will assist in providing state-of the-art information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement. As Medical Director, you will support various initiatives that drive better cost and quality through our national network: Optum. You will have the ability to lead and innovate within the health insurance industry by improving metrics through innovation.
- Perform concurrent review of facility-based member stays along with the RN Case Managers
- Conduct facility rounds with the Hospitalist on a regular basis
- Facilitate designated pre-service reviews for our members
- Review various analytical and metrics data to ensure quality of care and profitability
- Work and collaborate with our highly integrated clinics to develop projects for chronic illnesses and population health
- Serve on Chronic Illness committees as needed with other Optum Local Care Delivery Organizations
- Active unrestricted MD/DO physician NV license
- Current board certification or board eligibility
- 3 or more years of clinical practice experience post residency
- Strong understanding of evidence-based medicine (EBM) and managed care principles, as well as familiarity with current medical issues and practices
- Project management or active project participation experience
- Excellent presentation skills for both clinical and non-clinical audiences
- Substantial experience in using electronic clinical systems
- Hands-on utilization &/or quality management experience
- Mentoring and coaching experience
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Sorry,this is NOT an opportunity for Search Firm recruiters.