Requisition Number: 2328754 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. Here at Optum, we have an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs. The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost effective quality medical care is provided to members. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations - Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements - Engage with requesting providers as needed in peer-to-peer discussions - Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews - Participate in daily clinical rounds as requested - Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy - Communicate and collaborate with other internal partners 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. - Active unrestricted medical license and ability to obtain additional state medical licenses as needed - Board certification in Oncology or Hematology - 5+ years of clinical practice experience after completing residency training - Proven sound understanding of Evidence Based Medicine (EBM) - Demonstrated PC skills, specifically using MS Word, Outlook, and Excel Preferred Qualifications: - Texas or California License - Compact License - Experience in utilization review - Demonstrated data analysis and interpretation aptitude - Proven innovative problem-solving skills - Proven excellent presentation skills for both clinical and non-clinical audiences - Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Compensation for this specialty generally ranges from $248,500 - $373,000. 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. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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.

Requisition Number: 2336776 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. The Behavioral Medical Director is responsible for overseeing and guiding the Utilization Management team. This individual will interact directly with Psychiatrists, Behavioral Health Providers, and other clinical professionals, such as Psychiatric Nurses, who consult on various complex clinical scenarios, processes and programs. The Behavioral Medical Director is part of a team that manages development and implementation of evidence-based treatments and medical expense initiatives and will also advise leadership on system improvement opportunities. They are responsible for timely peer reviews, appeals and consultations with providers and other community-based clinicians, including general practitioners, and will work collaboratively with utilization management, care management, quality, account management, and operations teams. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Ensuring delivery of cost-effective quality care that incorporates recovery, resiliency, and person-centered services - Implementation of Level of Care guidelines and Utilization Management protocols - Provide clinical oversight and support to the clinical staff, oversee the management of services at all levels of care in the benefit plan - Keep current regarding Evidence Based Practices and treatment philosophies including those that address Recovery and Resilience The Behavioral Medical Director will support: - Clinical review and oversight of behavioral health cases in collaboration with multidisciplinary team members - Peer-to-peer consultations - Compliance with state regulations and licensure - Quality assurance and audit readiness for accreditation 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: - Doctor of Medicine or Osteopathy - Current license to practice as a physician without restrictions and willing to maintain necessary credentials to retain the position - Board certified in Psychiatry - Board certified in Child and Adolescent Psychiatry - Experience working in a multidisciplinary clinical team - Knowledge of post-discharge care planning such as home care, discharge planning, care management, and disease management - Computer and typing proficiency, data analysis, and organizational skills - Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals - Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation, and recovery - Demonstrated competence in use of electronic health records as well as associated technology and applications - Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues - Participate in rotational holiday and call coverage Preferred Qualifications: - 3+ years of experience as a practicing psychiatrist post residency - Managed care experience to include familiarity with Utilization Management guidelines - Familiar with behavioral services within the NY, NJ, CT Tri-State area; to include active licensure - Understanding of Medical Behavioral Integration and Whole Person Care concepts and application - Based in Eastern time zone - Willing to obtain additional state licensure, with support *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $268,000 to $414,000. 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.

Requisition Number: 2336685 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. Here at Optum, we have an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs. The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on post-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost effective quality medical care is provided to members. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations - Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements - Engage with requesting providers as needed in peer-to-peer discussions - Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews - Participate in daily clinical rounds as requested - Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy - Communicate and collaborate with other internal partners 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 - Active unrestricted medical license and ability to obtain additional state medical licenses as needed - Board certification in Internal Medicine - 5+ years of clinical practice experience treating Sleep and Pulmonology disorders, after completing residency training - Proven sound understanding of Evidence Based Medicine (EBM) - Demonstrated PC skills, specifically using MS Word, Outlook, and Excel Preferred Qualifications: - Texas or California License - Compact License - Experience in utilization review - Proven innovative problem-solving skills - Proven excellent presentation skills for both clinical and non-clinical audiences - Demonstrated data analysis and interpretation aptitude - Demonstrated excellent oral, written, and interpersonal communication skills, facilitation skills - Reside in PST, or MST *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $248,500 - $373,000. 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. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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.

Requisition Number: 2333791 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. Why Care Transitions? At Care Transitions, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. Care Transitions is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company's technical vision and strategy. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. We are currently looking for Medical Directors that can work daytime in any of the continental time zones in the US. Primary Responsibilities: - Provide daily utilization oversight and external communication with network physicians and hospitals - Daily UM reviews - authorizations and denial reviews - Conduct peer to peer conversations for the clinical case reviews, as neededConduct provider telephonic review and discussion and share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care - Communicate effectively with network and non-network providers to ensure the successful administering of Care Transitions' services - Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers - Represent Care Transitions on appropriate external levels identifying, engaging and establishing/maintaining relationships with other thought leaders - Collaborate with Client Services Team to ensure a coordinated approach to delivery system providers - Contribute to the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals - Interact, communicate, and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees - Provide leadership and guidance to maximize cost management through close coordination with all network and provider contracting - Regularly meet with Care Transitions' leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues - Provide input on local needs for Analytics Team and Client Services Team to better enhance Care Transitions' products and services - Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME - Participate on the Medical Advisory Board - Providing intermittent, scheduled weekend and evening coverage - Perform other duties and responsibilities as required, assigned, or requested 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: - Board certification as an MD, DO, MBBS with a current unrestricted license to practice and willing to maintain necessary credentials to retain the position - Current, unrestricted medical license and the ability to obtain licensure in multiple states - 3+ years of post-residency patient care, preferably in inpatient or post-acute setting Preferred Qualifications: - Licensure in multiple states - Willing to obtain additional state licenses, with Optum's support - Understanding of population-based medicine, preferably with knowledge of CMS criteria for post-acute care - Demonstrated ability to work within a team environment while completing multiple tasks simultaneously - Demonstrated ability to complete assignments with reasonable oversight, direction, and supervision - Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals - Demonstrated competence in use of electronic health records as well as associated technology and applications - Proven excellent organizational, analytical, verbal and written communication skills - Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues - Proven highest level of ethics and integrity - Proven highly motivated, flexible and adaptable to working in a fast-paced, dynamic environment *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $248,500 - $373,000. 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. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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.