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Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 4 industry leader.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Support of the Case Management nurses in daily review activities and external interaction and communication with network physicians

• Conducts daily and ongoing clinical review and evaluation of clinical care and services provided to plan members. Interacts, communicates, and collaborates with network physicians, hospital leaders, and other vendors regarding clinical care and services for enrollees

• Uses performance data to guide interactions

• Conducts provider telephonic review and discussion, schedules on-site visits, and shares tools, information, and guidelines related to quality, cost-effective health care delivery and quality of care. Regularly has peer-to-peer dialogue to review Case Management issues, develop collaborative intervention plans and share ideas about network management issues

• Documents case review findings, actions, and outcomes in accordance with Case Management policies; meets health plan inter-rater reliability guidelines

• Is available and accessible to the Case Management team throughout the day to respond to clinical issues. Serves as a clinical resource, coach, and leader for Case Management team

• Shares best practices with other medical directors and clinical leaders from other United Healthcare sites

• Participates in Case Management team meetings and rounds for communication, feedback, problem solving, staff training and development and sharing of program results

• Accesses clinical specialty panel physicians to assist in complex or difficult cases. Monitors utilization reports by product line, identifying changes in utilization or access patterns and monitor overall trends on a weekly basis

• Contributes to development of Affordability plans to implement strategic initiatives and tactics to address areas of concern and monitors progress towards goals

• Interacts with Network and provider relations to ensure coordinated approach to delivery system providers. Supports network accreditation efforts as determined by Clinical Science Institute

• Supports MBM growth initiatives through sales and marketing efforts through customer presentations. Participates in design and development of Case Management programs and national committees as requested

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Current and unrestricted MD or DO license

• Board certified in an AOBMS or ABMS specialty

• 5+ years clinical practice experience

Preferred Qualifications:

• Board certification or fellowship training in a Transplant sub- specialty

• 2+ years health plan or hospital experience as a Medical Director

• Program and product development experience

• Knowledge of managed care industry

• Solid background in the application of evidence-based medicine

• Ability to travel up to 25%

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 4, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The salary range for this role is $286,104 to $397,743 annually. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.