Serve as a leader within a cross-functional team spanning medical safety, clinical product risk and biostatistical analytics, demonstrating high ethical standards and accountability while advocating for medical safety across internal...

Title: Medical Director - Spine And Brain Surgery - Remote Location: United States Job Description: 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. As part of the Focus Claims Review team at Optum, the Medical Director provides leadership, organization, and direction for the claims review program. They are responsible for the overall quality, effectiveness and coordination of the medical services provided through Optum. The Medical Director will participate in all aspects of claim review services including provider telephonic discussions and provider appeals. In addition, the Medical Director may also be asked to assist in the direction and oversight in the development and implementation of policies and procedures and clinical criteria for all medical programs and services. The Medical Director will serve as a liaison between Optum, physicians, and other medical service providers in selected situations primarily related to medical claim reviews. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Reviews surgical and other professional claims for correct coding using clinical record - Participation in Training regarding URAC, NCQA, Regulatory Compliance, Confidentiality, Conflict of Interest, HIPAA, and department specific training as applicable - Discusses cases and clinical coding situations with treating providers telephonically during scheduled hours - Participates in periodic clinical conferences / calls and in ongoing internal performance consistency reviews - Composes, if needed, patient situation specific, clinical summaries and rationales for medical necessity decisions - Supports compliance with regulatory agency standards and requirements (e.g., CMS, NCQA, URAC, state / federal and third-party payers) - Provide Clinical support for staff that conduct initial reviews 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 in Neurological Surgery - 5+ years of clinical experience with brain and spine surgeries post residency - MS Office (MS Word, Excel, and Power Point) Preferred Qualifications: - Experience working for a managed care organization - Experience with professional claim coding / claim coding reviews - Knowledge of claim coding resources and techniques - Proficient computer skills and ability to learn to use clinical and claims software - Proven excellent interpersonal skills and the ability to work over the telephone with other colleagues including physicians, nurses, PTs, OTs and other similar personnel - All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $248,500.00 to $373,000.00. 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.

• Lead clinical development strategy and operations for active programs • Manage cross-functional study teams and oversee design and execution of clinical trials • Serve as Medical Lead and primary Medical Monitor for clinical trials • Prepare clinical development plans and regulatory documents in support of regulatory submissions • Communicate with key external stakeholders to facilitate development and oversight of compounds • Present clinical data at relevant advisory board meetings and/or scientific meetings

Role Description As a member of the US Therapy Area (TA) Field Medical Leadership Team, the Director of Field Medical Trial Acceleration is responsible for shaping the US TA Field Medical Trial Execution Strategy and providing trial pull-through and communications for the TA US Field Medical Organization. This role will partner with HQ Medical Direction, GDD, GCO, training, CSPTs, MTLs, and PanTA trial teams to ensure alignment with medical trial strategy and successful execution of FM trial objectives. - Set US clinical trial priorities with the TA National Director; execute recruitment/referral strategies and success metrics. - Lead development and delivery of the TA Field Medical Annual Clinical Trial Plan and quarterly action-plan trial inputs. - Coordinate and optimize trial recruitment and referral plans, including innovative approaches for new platforms. - Translate USMA/GMA trial strategy into actionable field initiatives, including insight gathering and investigator engagement. - Partner with Medical Direction, GDD, GCO, and cross-functional teams to align field initiatives with Medical/Clinical Trial Plans. - Develop processes and communications to convey impact of field initiatives and external stakeholder insights to internal partners. - Define and refine Key Intelligence Topics (KITS) and proactive field trial intelligence with SMEs, PTLs, MTLs, DSCs, and MDs. - Simplify and streamline cross-functional communication and alignment for clinical trial execution within Field Medical. - Ensure role clarity for Field Medical clinical-trial stakeholders (MTLs, CSPTs, DSCs, RDM advisors) and coordinate support with CTM. - Drive field trial communications and training/tool enablement with Training & Scientific Communications; incorporate learnings and coach MSLs/new hires. Qualifications - Doctoral degree (e.g., PharmD, PhD, MD). - 7+ years of Medical Affairs or relevant healthcare experience. - Demonstrated ability to navigate complex, matrixed, cross-functional, and global environments to swiftly drive decisions to action. - External customer-facing experience (e.g., MSL, Medical Director, clinical research); deep understanding of the clinical development programs and healthcare landscape impacting trial sites and patients. - Strong Medical Affairs capabilities, including strategic planning and execution/documentation of communication plans and initiatives. - Knowledge of relevant therapeutic area and disease management (Neuroscience or rare disease), medical research practices, alternative platforms, and healthcare/managed markets. - Excellent interpersonal communication and presentation skills; strong project management; high integrity, teamwork, customer focus, and ability to influence without authority. - Strong decision-making with a track record of leading and delivering across multiple projects, processes, or functions. Requirements - Driving is an essential function of this role; a fully valid and unrestricted driver’s license is required. - COVID-19 Vaccine Policy: Employees in customer-facing roles must adhere to and comply with customers’ credentialing guidelines, which may require vaccination. - For Field Roles with a Dedicated Training Period: Successful completion of certain initial training is required. Benefits - Salary range: $204,400 - $379,600 per year. - Performance-based cash incentive and eligibility for annual equity awards. - Comprehensive benefits package including health, life and disability benefits, a 401(k) with company contribution and match. - Generous time off package including vacation, personal days, holidays, and other leaves. Company Description The Novartis Group of Companies are Equal Opportunity Employers. We strive to create an inclusive workplace that cultivates bold innovation through collaboration and empowers our people to unleash their full potential.