Medical Director Clinical Advocacy and Support- DME, Musculoskeletal - Telecommute
- 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
- 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]
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
Posted September 14, 2021