Utilization Management Medical Director, Clinical Performance - California license - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

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 4 industry leader.

We are currently seeking a Utilization Management Medical Director to join our Clinical Performance team. This team is responsible for conducting hospital and post-acute utilization reviews for the state of California. The Medical Directors work with groups of nurses and support staff to manage inpatient care utilization.

You’ll enjoy the flexibility to work remotely * as you take on some tough challenges.

Primary Responsibilities:

• Work to improve quality and promote evidence-based medicine
• Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement
• Support initiatives that enhance quality throughout our national network
• Ensure the right service is provided at the right time for each member
• Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review

Required Qualifications:

• MD or DO degree
• Active, unrestricted California state license
• Current board certification in ABMS or AOA specialty
• 5+ years of clinical practice experience post residency
• Solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles

Preferred Qualifications:

• Hands-on utilization and/or quality management experience
• Project management or active project participation experience
• Substantial experience in using electronic clinical systems

About Optum

Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare. We’re a global organization that’s evolving health care so everyone can have the opportunity to live their healthiest life. With our hands across all aspects of health, we'll provide you with a rewarding career that enables you to grow in the directions that best fit your passions. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together.