Chief Medical Officer - UCS Clinical Assessment Review Expert

Chief Medical Officer – United Clinical Services (CAREs)

At United Healthcare, we simplify the health care experience, create healthier communities, and remove barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable.
Caring. Connecting. Growing together.

You’ll enjoy flexibility to work remotely from anywhere within the U.S. For all hires within 30 minutes of an office in Minnesota or Washington, D.C., you’ll be required to work a minimum of four days per week in‑office.

• Serve as an executive leader within the Office of Medical Management with accountability over the CARES team, including executive strategic vision and leadership across all key operations.
• Manage a team responsible for monitoring clinical, affordability, and operational outcomes.
• Provide strategic leadership in collaboration with operations, Medical Management pillar leads, Healthcare Economics – medical informatics, finance, network, and other key matrixed LOB partners through all phases of relevant UM programs, including Inpatient Concurrent Review, Prior Authorization, and Medical Claims Review.
• Work in partnership with enterprise operational, LOB partners, and Value Creation leadership to address gaps & deficiencies for existing clinical programs, as well as help inform clinical value for future medical management initiatives.
• Support the organization in identifying emerging clinical trends and shaping strategic direction. Collaborate with internal and external partners to publish high‑impact content focused on improving compliance, quality, and affordability.
• Evaluate clinical and other data (e.g., quality metrics, claims data, bed‑day data, usage data) to identify opportunities for improvement of clinical processes.
• Develop key messages and talking points for communicating clinical program outcomes to key external stakeholders.
• Proactively identify growth opportunities and deliver clinical support to Utilization Management teams, credentialing functions, and delegated entities. Create and maintain strong relationships with key clinical leaders across Optum, UHG, and external delegates.
• Participate in and lead key executive meetings, including LOB affordability leadership meetings, Value Creation Ideation Front Door, and LOB Joint Operating Committee.
• Effectively navigate challenging conversations with professionalism and emotional intelligence, particularly when addressing programs that impact compliance, quality, affordability, or involve areas of disagreement. Present clinical findings, remediation strategies, and anticipated outcomes to groups in a clear and impactful manner. Influence development of technical/clinical communications that will be delivered to external audiences (e.g., new clinical policies, programs, processes).
• Discuss oversight findings with internal or external parties (e.g., case managers, other medical directors, clinical providers, physicians).
• Provide feedback to team members and other departments to refine decision making and promote a shared understanding of clinical determinations and outcomes.
• Assess and interpret complex financial and clinical data to evaluate feasibility of proposed initiatives.
• Identify and implement development resources aligned with evolving business needs and regulatory requirements. Serve as a dyad partner with the Vice President of Clinical Strategy and Operations within Medical Management.
• Serve as a delegate to the National CMO of Medical Management for broader strategic decisions.

You will be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• Doctor of Medicine (MD or DO) degree with unrestricted medical license.
• 3+ years of experience delivering clinical and operational insights to executive audiences, with a solid ability to translate complex data into actionable strategies.
• 10+ years of clinical practice…