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 6 industry leader. Transforming health care and millions of lives starts with the values you embrace and the passion you bring. Find out more and join us. It's an opportunity to do your life's best work.(sm)
The Sr Medical Director will have oversight responsibility for the Specialty Pharmacy and Cancer Guidance Programs. They will also provide clinical guidance to help implement a next - generation comprehensive solutions which will successfully meet clinical, quality, and financial performance objectives. These solutions will help ensure providers deliver high-quality, evidence-based and cost-efficient care for our clients. As such, this role requires an innovative, hands-on, action-oriented clinical leader. This position will serve as a key leader dedicated to helping ensure high levels of quality, affordability, and member and provider satisfaction.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges
- Serve as a subject matter expert in evidence-based guidelines - especially those produced by the National Comprehensive Cancer Network (NCCN) - and help ensure all clinically relevant policies and processes are informed by the best available evidence
- Lead a team of physicians responsible for performing utilization review determinations for medical and radiation oncology and specialty pharmaceutical treatments, as well as support case and disease management teams to achieve optimal clinical outcomes
- Perform quality audits on utilization review determinations, identify improvement opportunities and develop/implement process changes
- Work closely with product and clinical operations on work force management models and staffing needs
- Engage & collaborate with treating providers telephonically. This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense
- Enhance clinical expertise of the Oncology team through education sessions with nursing and pharmacy teams, and serving as a thought leader and point of contact for relevant medical societies & stakeholders
- Deliver the Optum clinical value proposition focused on quality, affordability and service, in support of the sales and growth activities including conducting client presentations and participating in customer consultations
- Provide clinical guidance in the refinement of utilization management solutions
- Evaluate clinical and other data (e.g., quality metrics, claims & health record data, utilization data) to identify opportunities for improvement of clinical care and processes
- Collaborate with operational and business partners on enterprise - wide research, clinical and quality initiatives to enhance Optum impact in the oncology field
At Optum, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.
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.
- MD or DO with an active, unrestricted medical license
- Current Board Certification in an ABMS or AOBMS specialty; Oncology
- 5+ years clinical practice experience (inclusive of Oncology)
- Minimum of 3 years of Team Lead and/or Supervisory experience
- Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development and / or peer review
- Experience working with NCCN guidelines
- Experience in client - facing customer relationship management
- Proven ability to quickly gain credibility, influence and partner with staff and the clinical community
- If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders.
- Experience in managed care, quality management or administrative leadership
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)
Colorado Residents Only: The salary/hourly range for Colorado residents is $293,200 to $324,800 (add additional reference for sales and physicians). Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.
Job Keywords: Senior Medical Director, Oncology, Pharmacy, Telecommute, Leadership, utilization management, case management, disease management, quality management, product development, peer review