Requisition Number: 2349105 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. Responsible, in part, as a member of a team of medical directors, for the overall quality, effectiveness and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects of the utilization review staff activities, and participates in the Quality Improvement programs for the company. The Medical Director also provides/assists in the direction and oversight in the development and implementation of policies, procedures and clinical criteria for all medical programs and services and may serve as a liaison between physicians, and other medical service providers in selected situations. 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. The focus of the coverage reviews will be various types of musculoskeletal and other medical/surgical services which will include prior authorizations for Pain Management procedures ( e.g. spinal chord stimulators, pain pumps, nerve ablations, facet injections, etc.) - Document clinical review findings, actions and outcomes in accordance with policies, and regulatory and accreditation requirements. Supports compliance with regulatory agency standards and requirements (e.g., CMS, NCQA, URAC, state / federal and third-party payers) - Works with clinical staff to coordinate all the necessary UM processes and provides feedback to staff who do portions of the UM reviews - Participation in Training regarding URAC, NCQA, Regulatory Compliance, Confidentiality, Conflict of Interest, HIPAA, and department specific training as applicable - Discusses cases and clinical situations with treating providers telephonically during scheduled hours - Participates in periodic clinical conferences / calls and in ongoing internal performance consistency reviews - Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews - Participate in rotational call coverage. Is available for occasional, periodic weekend and holiday as needed telephonic and remote computer expedited clinical decisions - Provide Clinical support for staff that conduct initial reviews - Good understanding of professional performance measurement and related possible discussions/interventions with selected providers/groups/organizations 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: - Current, active, and fully unrestricted medical license - Current Board Certification and must maintain pain subspecialty with specialty in either PM&R or Anesthesia - 5+ years clinical experience post residency in Pain subspecialty - Proficient with MS Office (MS Word, Email, Excel, and Power Point) - Excellent computer skills and ability to learn new systems and software - Excellent interpersonal skills and the ability to work over the telephone with other colleagues including physicians, nurses, PTs, OTs and other similar personnel - Participate in rotational call coverage - Must be willing and able to obtain additional medical licenses as needed Preferred Qualifications: - License in North Carolina or New Mexico - Experience in managed care UM activities - Possess leadership skills in working with other physicians, knowledge of the overall medical community and the local / regional managed care environments - Experience with integration of clinical and financial data, development of utilization and performance reporting tools, and communication of performance data to physicians and other health care providers *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 to $357,500. 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 UnitedHealth Group, 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.

• Lead the overall strategy, design, and execution of clinical and pre-clinical development programs • Develop scientifically rigorous clinical trial protocols and ensure regulatory and ethical compliance • Oversee preparation of core materials, including clinical development plans, regulatory submissions, and study documentation • Present program strategies and outcomes to internal and external stakeholders, including executive leadership and advisory boards • Collaborate with contract research organizations (CROs), academic partners, and cross-functional teams to ensure successful trial delivery • Partner with regulatory authorities and scientific collaborators to support study progress and milestone achievement • Manage budgets, timelines, and risks to ensure excellence in clinical program execution

Lead the strategic planning and execution of Phase IIIb/IV trials, develop medical affairs strategies, and collaborate with cross-functional teams to advance research and enhance understanding of autoimmune diseases.

In the U.S., 60% of adults – more than 133 million people – live with at least one chronic condition. These patients need frequent, proactive support to stay healthy, yet our care system isn’t built for that level of attention. With rising clinician shortages, strained infrastructure, and reactive care models, patients too often end up in the ER or the hospital when those outcomes could have been prevented. At Cadence, we’re building a better system. Our mission is to deliver proactive care to one million seniors by 2030. Our technology and clinical care team extend the reach of primary care providers and support patients every day at home. In partnership with leading health systems, Cadence consistently monitors tens of thousands of patients to improve outcomes, reduce costs, and help patients live longer, healthier lives. The Cadence Health team is seeking a remote Certified Medical Assistant (internally known as a Clinical Navigator) to provide virtual patient support across Cadence care programs. In this role, you will support Medicare patients living with chronic conditions by reinforcing care plans, encouraging adherence to medications and preventive care, and providing education that helps patients better manage their health. Clinical Navigators deliver proactive, patient-centered outreach and follow-through. Depending on program needs, your work may include structured patient check-ins, coaching and goal-setting, care coordination to close gaps in care, and addressing barriers such as access to resources, transportation, or medication refills. You will document patient interactions in the Cadence platform and collaborate closely with the clinical team to escalate concerns, coordinate next steps to ensure patients feel supported, informed, and engaged throughout their care journey. Schedule: This is a full-time, remote position based in the United States. Standard working hours are Monday through Friday, from 8:00 AM to 5:00 PM or 9:00 AM to 6:00 PM in the Hawaii time zone. What you'll do: - Conducting outbound telephonic patient outreach to support patients enrolled in Cadence care programs - Provide one-on-one coaching and support to patients managing chronic conditions, including but not limited to type 2 diabetes, hypertension, and cardiovascular disease - Help patients execute personalized care plans and achieve their goals by providing education and coaching focused on behavior modification, nutrition, physical activity, and self-management strategies using evidence-based techniques such as motivational interviewing and SMART goals - Conduct comprehensive assessments of patients' health status, lifestyle behaviors, nutritional habits, and readiness to change - Support patient care delivery by performing assigned tasks in accordance with Cadence clinical policies and established protocols, under appropriate clinical supervision - Educate patients on disease management, medication adherence, symptom recognition, and prevention strategies - Monitor patients' progress, adherence to treatment plans, and health outcomes through regular check-ins and remote monitoring tools - Documenting patient interactions, outcomes, and follow-up plans in the Cadence platform - Identifying barriers to care (including social needs) and connecting patients with resources or internal support pathways - Collaborating in real time with clinicians and patient support teams using tools such as our Cadence Platform, Google Workspace, and Slack - Contributing feedback to improve workflows in a fast-moving, change-oriented environment These responsibilities are intended to describe the general nature and level of work being performed by personnel assigned to this job classification. They are not to be construed as an exhaustive list of job duties performed by personnel in this classification. Other job related duties may be assigned by management. What you need: Education, licenses, and experiences required for this role: - Must be currently located in Hawaii - An active Medical Assistant certification from an accredited association (either AAMA, AMCA, AMT, NHA, NAHP or NCCT) is required - At least 5 years of experience as a Medical Assistant is required - Remote work readiness (including stable high-speed WiFi) is required - Experience working in internal medicine, cardiology, nephrology or with the geriatric population is preferred - Experience providing patient education and support to individuals managing chronic conditions is preferred Cadence Clinical Navigators also demonstrate: - Strong patient education, coaching, and care coordination skills - Skilled in supporting patients in managing their health and chronic conditions by meeting them where they are in life - considering their age, lifestyle, and diet - Strong documentation habits and attention to detail - Reliable attendance and strong schedule adherence - Exceptional written, verbal, and interpersonal communication skills - Ability to work independently in a remote, fast-paced environment with evolving workflows - Tech-savvy and comfortable navigating and/or troubleshooting multiple systems while engaging patients virtually The anticipated compensation range for this role is $22 - $26 per hour, which is based on role scope, level, and location. In addition to base compensation, this role may be eligible for incentive compensation as part of the overall total rewards package. This position is remote and based in the United States. Actual compensation will be determined based on factors including experience, skills, internal equity, and applicable law. Who we are Cadence Health was built around a simple promise: patients always come first. Our technology-enabled remote care model pairs continuous health insights with a highly skilled clinical Care Team, empowering seniors to stay healthier, avoid complications, and live more independent, fulfilling lives, all without the limits of a traditional office visit. Your expertise is the heart of our system. Nurse practitioners, registered nurses, medical assistants, patient-success coordinators, and other frontline clinicians are the face and beating heart of Cadence. You’ll bring warmth, clinical precision, and the empathy that turns a virtual touchpoint into a human connection. Every chat, phone call, and care plan you deliver shapes how patients experience “what healthcare should be.” A modern toolkit to practice top-of-license care We’ve replaced reactive visits with real-time data, intelligent workflows, and seamless collaboration tools. That means you can spend less time on busywork and more time practicing at the top of your license, coaching patients, spotting risks early, and coordinating with physicians to keep care proactive and personal. Thriving in a fast-moving, mission-driven culture. Change excites us. Innovation fuels us. If you’re energized by technology, eager to re-imagine care delivery, and motivated to improve outcomes for both patients and the providers who serve them, you’ll feel at home here. We invest in continuous learning, clinical mentorship, and transparent growth paths so you can advance your skills while making a measurable impact every day. Join us in redefining healthy aging. If you’re passionate about compassionate care and ready to transform how seniors across the country manage chronic conditions, recover after hospitalization, and age with confidence, let’s talk. Together, we’ll build a future where exceptional care is consistent, connected, and just a call away. What You'll Get: Cadence full-time employees are eligible for the benefits described below. Part-time employees may qualify for benefits mandated by state or local law. Cadence recognizes the unique needs of its diverse, distributed workforce and seeks to provide an inclusive work environment for its world-class clinicians and technologists. - Company culture all about impact, shared growth mindset, empowerment, and integrity - An opportunity to help improve the quality of life of millions of Americans - Unique chance to support the development of an amazing product; Cadence’s in-house clinicians are our super users and beta testers - Competitive salaries and quarterly incentives - Medical, dental, and vision insurance - Competitive PTO - 401K and 401K match - National and local discounts powered by TriNet - Onboarding stipend for remote equipment and home office setup - Paid Parental Leave - Charitable Donation Match program We are committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws. Candidates must be willing to comply with all pre-employment drug screening requirements and, where applicable, comply with additional drug screening requirements as a condition of continued employment in accordance with company policy and applicable law. *A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at https://www.cadence.care/our-team. Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence.