Description

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.

This key clinical leadership position will lead and share responsibility for the development and delivery of current, consistent, accurate, evidence-based clinical content for the InterQual Care Planning content suite focused on content designed to define screening criteria for clinical appropriateness used in medical necessity reviews and support other InterQual content modules as required. Areas of focus include advanced procedures and imaging, specialty referral, specialty pharmacy, durable medical equipment, molecular diagnostics, and Medicaid policies. Responsible for assuring accuracy, consistency, and evidence basis for the content. Works directly with clinical content development (CCD) staff and the Clinical Lead (CL) to create, review, comment, advise on content and sign off on clinical content releases. Collaborates with other Medical Directors, Senior Medical Directors, the Vice-President, Assistant Vice-President (AVP), Director of Content Products, Product Management, and Clinical Strategy to deliver market leading criteria products. Supports Sales and Account Management, regulatory affairs, internal and external education, training and related activities as required.

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

Primary Responsibilities:

• Work with CCDs to develop and assure clinical content accuracy, currency, and consistency with the literature-based evidence and relevance to InterQual content, as well as Medicaid policies for a new product offering. Provide guidance to CCDs based on critical appraisal of medical literature and practice experience regarding clinical content
• Creates and/or updates content
• Participates in development meetings
• Reviews content drafts
• Performs content QA using tools & techniques assuring clinical accuracy
• Signs off on content as final and clinically accurate
• Collaborate with product management, product development, clinical strategy, and clinical development teams to develop and re-structure clinical content for different users, applications and contexts
• Work with fellow Medical Directors and other clinical managers to assure clinical content and decision support consistency within and across all InterQual products
• Serve as a clinical resource for both internal and external customers. Accompany the Sales and/or Regulatory/Public Affairs teams on calls, onsite visits and provide support and consultation as needed
• Applies knowledge gained through professional development and communicates it to internal and/or external parties
• Interfaces with clients to provide clinical leadership and support as well as gain an understanding of client needs in collaboration with the Product Owner, Client Experience Team, and Product Management
• Help address and resolve clinical questions/issues identified by clients. Apply knowledge gained through direct patient care experience and professional development activities and communicates it to internal and/or external parties

You'll 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.

Required Qualifications:

• M.D. or D.O.
• Current, active, and fully unrestricted Medical License in good standing to practice medicine in a U.S. state
• Medical Board Certification
• 5+ years of experience in direct patient care delivery in the U.S.
• Demonstrated medical writing experience and understanding of the evidence-based medicine process, including critical appraisal of the published peer-reviewed literature
• Proven track record of leadership, decision making, and working in a collaborative, team-focused approach
• Willing/able to travel approximately 10% of the time when and if business needs dictate

Preferred Qualifications:

• Experience with teaching, clear communication, and leadership to forge relationships with clinical teams, stakeholders, senior management, and external customers
• Managed care/Payer industry knowledge and experience
• Knowledge of InterQual criteria

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Compensation for this specialty generally ranges from $124,500 - $239,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.