Medical Director Clinical Advocacy and Support- DME, Musculoskeletal - Telecommute

Arcadia, CA

full-time
Outpatient

Primary Responsibilities

  • Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations.
  • Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements.
  • Engage with requesting providers as needed in peer-to-peer discussions.
  • Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews.
  • Participate in daily clinical rounds as requested.
  • Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy.
  • Communicate and collaborate with other internal partners.
  • Call coverage rotation

Required Qualifications:

  • M.D or D.O.
  • Board certification approved by the American Board of Medical Specialties (ABMS)
  • Active unrestricted license to practice medicine
  • 5+ years of clinical practice experience after completing residency training
  • Sound understanding of Evidence Based Medicine (EBM)
  • Solid PC skills, specifically using MS Word, Outlook, and Excel
  • If you nee ...For complete description tap [HERE][1]

Colorado Residents Only: The salary range for Colorado residents is $110,200 to $211,700. 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/13852642/medical-director-clinical-advocacy-and-support-dmepos-msk-telecommute-remote/


Posted September 14, 2021