Role Description We are looking for physicians who have expertise in Orthopedic Spine Surgery to deliver on Cohere’s musculoskeletal and orthopedic programs by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. Reporting to the Managing Medical Director, MSK Spine and Ortho for Cohere Health, and part of the review team that includes non-clinical intake specialists and nurses, this is a critical role in a Series B company that is rapidly scaling to impact millions of patients. This is a fast-paced environment that favors people who are able to learn quickly, be hands-on, handle ambiguity, and communicate effectively with people of different backgrounds and perspectives. - Provide timely medical reviews that meet Cohere’s stringent quality parameters - Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen - Clearly and accurately document all communication and decision-making in Cohere workflow tools, ensuring a member and provider can easily reference and understand your decision - Use correct templates for documenting decisions during case review - Meet the appropriate turn-around times for clinical reviews - Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research - Demonstrate the highest level of professionalism, accountability, and service in your interactions with Cohere teammates and providers - Support projects specific to building the team's clinical expertise and efficiency, as delegated - Support the team on operational improvements and member/provider experience involving clinical review tasks, as delegated Qualifications - Completed US-based residency program in Orthopedic or Neurosurgery Surgery and fellowship program in Spine Surgery - Board certification as an MD or DO with a current unrestricted state license to practice medicine - reviewers must maintain necessary credentials to retain the position - 5+ years of clinical practice beyond residency/fellowship - 1+ years of managed care utilization review experience - Membership in national and/or regional specialty societies - Licensure in AZ, GA, MS, NC, ND, OK, OR, or TX is highly desirable - you should be willing to obtain additional state licenses with Cohere's support Benefits - 💻 Fully remote opportunity with about 5% travel - 🩺 Medical, dental, vision, life, disability insurance, and Employee Assistance Program - 📈 401K retirement plan with company match; flexible spending and health savings account - 🏝️ Flex Time Off + company holidays - 👶 Up to 14 weeks of paid parental leave - 🐶 Pet insurance Interview Process - Connect with Talent Acquisition for a Preliminary Phone Screening - Meet your Hiring Manager! - Behavioral Interview(s)

Title: Part-Time Behavioral Medical Director - Licensed in Minnesota - Remote Location: Remote, United States Requisition number: 2364350 Job category: Behavioral Primary location: Minneapolis, MN Additional locations: Chicago, Illinois | Indianapolis, Indiana | Rochester, Minnesota | Eden Prairie, Minnesota | Bloomington, Minnesota | Las Vegas, Nevada | Dallas, Texas | Green Bay, Wisconsin Overtime status: Exempt Travel: No 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. The Part-Time Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management Program and performing peer reviews as necessary. This individual will interact directly with Psychiatrists, Behavioral Health Providers, and other clinical professionals who consult on various processes and programs. The Behavioral Medical Director is part of a leadership team that manages development and implementation of evidence-based treatments and medical expense initiatives and will also advise leadership on health care system improvement opportunities. They are responsible for maintaining the clinical integrity of the program, including timely peer reviews, appeals and consultations with providers and other community-based clinicians, including general practitioners, and will work collaboratively with the Health Plan Medical Director, Clinical, Network and Quality staff. At Optum, our clinical vision drives the team to improve the quality of care our consumers receive. 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 - Responsible for Level of Care guidelines and utilization management protocols - Oversight and management, along with the Clinical Director and Clinical Program Director, utilization review, management and care coordination activities - Provide clinical oversight 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 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 in the state of Minnesota (residence not required) - Board certified in Psychiatry - Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management - Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recovery - Computer and typing proficiency, data analysis and solid organizational skills - Ability to work a minimum of 20 hours per week Preferred Qualifications: - 3+ years of experience as a practicing psychiatrist post residency - Managed care experience - Experience in public sector delivery systems and experience in state specific public sector services - Experience working with community-based programs and resources designed to aid the State Medicaid population - All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $268,000 - $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. 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.

Title: Utilization Management Medical Director - Medical Oncology - Remote anywhere in US Location: Houston 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. The Medical Director Oncology will provide utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes - Serve as a subject matter expert in evidence - based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidence - Engage and collaborate with treating providers telephonically; This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense - Enhance clinical expertise of the Oncology team through education sessions with nursing teams, and serving as a thought leader and point of contact for relevant medical societies and stakeholders - Evaluate clinical and other data (e.g., quality metrics, claims and health record data, utilization data) to identify opportunities for improvement of clinical care and processes - Collaborate with operational and business partners on enterprise-wide research and clinical and quality initiatives to enhance Optum impact in the oncology field 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: - MD or DO with an active, unrestricted medical license - Obtain additional licenses as needed - Current Board Certification in an ABMS or AOBMS specialty in Oncology - 5+ years of clinical practice experience (inclusive of Medical Oncology) - Experience working with NCCN guidelines - Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development, and/or peer review - Proven ability to participate in rotational holiday and call coverage Preferred Qualification: - Experience in managed care and quality management - 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.

Title: Medical Director Oncology - Utilization Management Location: Minneapolis 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Medical Director Oncology will provide utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes - Serve as a subject matter expert in evidence - based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidence - Engage and collaborate with treating providers telephonically; This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense - Enhance clinical expertise of the Oncology team through education sessions with nursing teams, and serving as a thought leader and point of contact for relevant medical societies and stakeholders - Evaluate clinical and other data (e.g., quality metrics, claims and health record data, utilization data) to identify opportunities for improvement of clinical care and processes - Collaborate with operational and business partners on enterprise-wide research and clinical and quality initiatives to enhance Optum impact in the oncology field 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: - MD or DO with an active, unrestricted medical license - Obtain additional licenses as needed - Current Board Certification in an ABMS or AOBMS specialty in Oncology - 5+ years of clinical practice experience (inclusive of Medical Oncology) - Experience working with NCCN guidelines - Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development, and/or peer review - Participate in rotational holiday and call coverage Preferred Qualification: - Experience in managed care and quality management - All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy The salary range for this role is $238,000 to $357,500 annually based on full-time employment. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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.