Medical Director, Utilization Management Physician - Optum - Remote

About this role

WellMed, part of the Optum family of businesses, is seeking an internal medicine or family medicine physician to join our Utilization Management team. Optum is a clinician-led care organization that is changing the way clinicians work and live. The Medical Director for Utilization Management will support WellMed Medical Management, Inc

by making utilization management determinations, identifying utilization trends suggesting possible over or under utilization of services and proactively suggesting improvements to WellMed Medical Management's utilization management program. 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 at home. Experience 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. Position Highlights & Primary Responsibilities: Assists in development and maintaining an efficient UM program to meet the needs of the health plan members and commensurate with company values Remain current and proficient in CMS criteria hierarchy and organizational determination processes Participates in case review and medical necessity determination Maintain proficiency in compliance regulations for both CMS and delegated health plans Conducts post service reviews issued for medical necessi

Apply for this role on UnitedHealth Group’s official careers site.