Medical Director - Outpatient Clinical Review - Remote

Optum is seeking a Medical Director for utilization management review to join our team. Optum is a clinician‑led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you’ll be an integral part of Optum’s vision to make healthcare better for everyone. At Optum, you’ll have the clinical resources, data, and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim.

We believe you deserve an exceptional career and will empower you to live your best life at work and erience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone.

Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

You’ll enjoy the flexibility to work remotely
* from anywhere within the U.S. as you take on some tough challenges.

• Work to improve quality and promote evidence‑based medicine through outpatient utilization management review
• Work with medical director teams focusing on outpatient and inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review
• 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
• Success in this technology‑heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production‑driven setting

• MD or DO degree
• Active, unrestricted physician 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

• Hands‑on utilization and/or quality management experience
• Project management or active project participation experience
• Substantial experience in using electronic clinical systems
• Active, unrestricted physician California state license

The scope of this role will include Prior Authorization for Medicare Advantage members focusing on high value procedures such as Myocardial SPECT, PET scans, DME/Home Ventilator, Genetic Testing, and many more. Additionally, the team handles UM functions for the Arizona and New Mexico markets.

• Be part of a best‑in‑class employee experience that enables you to practice at the top of your license
• We believe that better care for clinicians equates to better care for patients
• We are influencing change collectively on a national scale while still maintaining the culture and community of our local care organizations
• Practice medicine autonomously, with the support, not restrictions, of a sustainable and thriving national health care organization

• Guaranteed, competitive compensation model based on quality, not quantity, with significant earning potential, annual increases, and bonus eligibility
• Financial stability and support of a Fortune 5 Company
• Robust retirement offerings including employer funded contributions and Employee Stock Purchase Plan (ESPP for UHG Stock)
• Physician and APC Partnership opportunities and incentives
• Comprehensive benefits plan inclusive of medical, dental, vision, STD/LTD, CME and malpractice coverage
• Robust clinician learning and development programs

* All employees working remotely will be required to adhere to United Health Group’s Telecommuter Policy

Compensation for this specialty generally ranges from $ to $. Total cash compensation includes base pay and bonus and is based on several factors…