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)
The Pain Management Medical Director is responsible, in part, as a member of a team of medical directors, for the overall quality, effectiveness and coordination of the medical review services provided through OrthoNet/Optum. The Medical Director performs Utilization Management reviews and participates in the Quality Improvement programs for the company. The Medical Director will also participate in the monitoring of patient care progress, treating physician medical decision making in the context of utilization management and perform provider appeals. The Medical Director may serve as a liaison between OrthoNet, physicians, and other medical service providers in selected situations.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Performs utilization management reviews for various types of pain management procedures and related services
- Works with OrthoNet clinical staff to coordinate all the necessary UM processes Participation in Training regarding URAC, NCQA, Regulatory Compliance, Confidentiality, Conflict of Interest, HIPAA, and department specific training as applicable
- Discusses cases and clinical situations with treating providers telephonically during scheduled hours
- Participates in periodic clinical conferences / calls and in ongoing internal performance consistency reviews
- Composes, if needed, patient situation specific, clinical summaries and rationales for medical necessity decisions
- Is available for occasional, periodic weekend and holiday as needed telephonic and remote computer expedited clinical decisions
- Ability to assist in marketing presentations to clients and ongoing relationship management activities with existing clients if requested to do so
- Provide Clinical support for staff that conduct initial reviews
- Good understanding of professional performance measurement and related possible discussions/interventions with selected providers/groups/organizations
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.
- Current, active and fully unrestricted Medical license
- Board certification in Pain Management
- 5+ years clinical experience in Pain Management post residency
- Proficient with MS Office (MS Word, Email, Excel, and Power Point)
- Excellent computer skills and ability to learn new systems and software
- Excellent interpersonal skills and the ability to work over the telephone with other colleagues including physicians, nurses, PTs, OTs and other similar personnel
- ABMS or other nationally recognized further specialized certifications
- Experience in managed care UM activities
- Must possess leadership skills in working with other physicians, knowledge of the overall medical community and the local / regional managed care environments
- Experience with integration of clinical and financial data, development of utilization and performance reporting tools, and communication of performance data to physicians and other health care providers
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Colorado Residents Only: The salary range for Colorado residents is $254,600 to $295,200. 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.
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: Pain Management Medical Director, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote