This job is archived
Community and State Medical Director - North Carolina
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 Charlotte, North Carolina, United States
Visa Sponsorship No

Job Description

Last Update: 4/13/21

Community and State Medical Director – North Carolina

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 and help people live healthier lives. Come to UnitedHealth Group, and share your ideas and your passion for doing more

We are currently seeking a Medical Director to join our UnitedHealthcare of North Carolina team. This team is responsible for supporting the Medicaid, DSNP and Exchange populations. The Medical Director will report to the North Carolina Chief Medical Officer and will be responsible for supporting care management, utilization management and population health improvement efforts.

You’ll enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Support the development of a successful clinical program for Medicaid, DSNP and Exchange populations in NC
  • Engage in developing innovative health models that achieve improved health outcomes
  • Promote evidence-based medicine by providing information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement
  • Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence – based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expenses
  • Conduct clinical reviews and render coverage determinations
  • Participate in clinical rounds and support care management activities
  • Work with other medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review
  • Represent UHC externally in healthcare/provider meetings, various association/organization meetings, State and other constituent meetings/presentations

Required Qualifications:

  • MD or DO degree
  • Physician, licensed to practice in North Carolina and in good standing
  • Current board certification in ABMS or AOA specialty
  • 5+ years of clinical practice experience
  • Strong understanding of and concurrence with evidence-based medicine (EBM) and managed care principles
  • Must reside in North Carolina

Preferred Qualifications:

  • Hands-on utilization and/or quality management experience
  • Demonstrated leadership skills
  • Innovative problem-solving skills
  • Proven ability to develop strategies, tactics and partner across organizations
  • Clinical experience within the past 2 years
  • 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 at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to 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.