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Appeals and Grievances Medical Director - Virtual - Western U.S.
Eden Prairie, Minnesota, United States

Job Summary

Occupation Physician
Specialty Medical Director
Degree Required MD/DO
Position Type Permanent/Full-Time
Work Environment Hospital Clinic/Private Practice
Location Los Angeles, California, United States
Visa Sponsorship Yes

Job Description

Last Update: 9/09/19

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 6 industry leader.
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
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.

Required Qualifications
? MD or DO degree
? Active, unrestricted physician state license
? Current board certification in ABMS or AOA specialty
? 5+ years of clinical practice experience post residency
? Strong 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
Transforming health care and millions of lives starts with the values you embrace and the passion you bring. Find out more and join us. It's an opportunity to do your life's best work.SM

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM


Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.


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