UM Medical Director - Neurosurgeon - Telecommute

White Plains, NY

full-time
Outpatient

Primary Responsibilities:

  • Performs utilization management reviews for various types of musculoskeletal and other medical/surgical services which may include PT OT ST, home health care, SNF, LTAC and acute inpatient rehabilitation services
  • Works with OrthoNet clinical staff to coordinate all the necessary UM processes and provides feedback to OrthoNet staff who do portions of the UM reviews
  • 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
  • Supports compliance with regulatory agency standards and requirements (e.g., CMS, NCQA, URAC, state / federal and third-party payers)
  • Provide Clinical support for staff that conduct initial reviews; which could include consolations with NP’s or CM’s
  • Demonstrate good ...For complete description tap [HERE][1]

Colorado Residents Only: The salary range for Colorado residents is $254,600 to $295,200. The 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 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.

[1]: https://careers.unitedhealthgroup.com/job/13180915/um-medical-director-neurosurgeon-telecommute-remote/


Posted June 24, 2021