• Job Description

  Req#: 2156110

  Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

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

  Primary Responsibilities:

  • Work to improve quality and promote evidence-based medicine
  • Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement
  • Support initiatives that enhance quality throughout our national network
  • Ensure the right service is provided at the right time for each member
  • Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review
  • Success in this technology-heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production-driven setting

  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:

  • MD or DO degree
  • Active, unrestricted physician state license
  • Current board certification in ABMS or AOA specialty
  • 5+ years of clinical practice experience post residency
  • 1+ years of Medicare Prior Authorization experience
  • Demonstrated solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles

  Preferred Qualifications:

  • Utilization and/or quality management experience
  • Project management or active project participation experience
  • Substantial experience in using electronic clinical systems
  • Innovative with ideas to better serve our members

  Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

  OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

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

  California, Colorado, Connecticut, Nevada, New York City, or Washington Residents Only: The salary range for California/Colorado/Connecticut/Nevada/New York City/Washington residents is $248,582 to $338,965. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

  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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

  OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

• About the company

  UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota.

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