Role Description Join MedPOINT Management as an Outpatient UM Clinician in Sherman Oaks, CA, where you will play a vital role in ensuring quality care for our patients. Be part of a dynamic team dedicated to improving patient outcomes through effective utilization management. Responsibilities: - Conduct utilization reviews for outpatient services to ensure compliance with standards. - Collaborate with healthcare providers to assess patient needs and treatment plans. - Document and track patient progress and treatment outcomes. - Communicate with insurance companies regarding authorizations and appeals. - Provide education and support to patients and families regarding care options. - Participate in quality improvement initiatives to enhance service delivery. - Stay updated on industry regulations and best practices in utilization management. - Assist in training and mentoring new staff on UM processes. Qualifications - Licensed clinician with a background in nursing, social work, or a related field. - Minimum of 2 years of experience in utilization management or case management. - Strong understanding of healthcare regulations and insurance processes. - Excellent communication and interpersonal skills. - Ability to work collaboratively in a fast-paced environment. - Proficient in electronic health records and documentation practices. - Detail-oriented with strong analytical and problem-solving skills. - Commitment to patient-centered care and quality improvement. Requirements - Licensed clinician with a background in nursing, social work, or a related field. - Minimum of 2 years of experience in utilization management or case management. - Strong understanding of healthcare regulations and insurance processes. - Excellent communication and interpersonal skills. - Ability to work collaboratively in a fast-paced environment. - Proficient in electronic health records and documentation practices. - Detail-oriented with strong analytical and problem-solving skills. - Commitment to patient-centered care and quality improvement. Benefits - 401(k) - 401(k) matching - Company parties - Dental insurance - Employee discounts - Free food & snacks - Health insurance - Opportunity for advancement - Paid time off - Parental leave - Savings bank - Training & development - Vision insurance - Wellness resources Company Description MedPOINT Management has been a leader in outpatient management solutions for over a decade. Our commitment to quality care and patient satisfaction has earned us the trust of both our clients and employees, creating a supportive and rewarding work environment.

Role Description The UHC Senior Medical Director of Clinical Program Governance & Standardization is part of the UCS Clinical Evidence Group. This physician is responsible for supporting and driving key clinical program governance, clinical standardization, and clinical evidence alignment processes in close collaboration with the National CMO of the UCS Clinical Evidence Group. The portfolio of efforts for which the incumbent will provide support, oversight, and leadership includes: - The UHC Clinical Program Governance process, which ensures deployed clinical programs are clinically sound, effective, carefully monitored, and advance enterprise goals. - The core process (Clinical Program Review (CPR)) evaluates ~50 clinical programs annually for program performance and design as well as alignment with member and health plan needs. - The process aims to optimize clinical program investments, ensuring that the portfolio reflects the best opportunity to improve health, enhance experience, and reduce unwarranted spending. - Support of early program development through the clinical program Ideation Front Door (IFD) process. - Clinical review of vendor candidates for the UHC & Optum Hub and Store (~40/year). - UHC’s participation in cross-industry efforts to advance standards and reduce friction for members and providers. The incumbent will report to the National CMO of the Clinical Evidence Group. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Qualifications - Masters level degree (or higher) in statistics, epidemiology, health services research or a related field. - Board certified physician in an ABMS/AOBMS Specialty. - Active/unrestricted U.S. Medical Licensure. - 5+ years of experience as a clinician (MD, DO or equivalent). - 3+ years of experience in health plan administration, health services research, quality assurance or comparable experience. - 3+ years serving as a consultant or leading a team on point for care quality improvement or product development and production. - Deep understanding of health plan medical policies, utilization management processes, and interpretation of data-rich reports related to utilization management programs. - Proficient in Excel, PowerPoint, Teams, Outlook and SharePoint. - Demonstrated ability to understand and efficiently interpret expansive data on clinical performance, program ID Strat (inclusion & exclusion criteria), financial impact data as well as program auditing and compliance review results. - Demonstrated ability to work collaboratively with clinicians, administrators and customers. - Demonstrated ability to drive process standardizations without suppressing creativity. - Demonstrated ability to navigate complex conversations with external partners, customers and providers who may challenge product specifications or analytic methods. - Demonstrated flexibility, agility and the ability to adapt to change while staying organized and maintaining solid relationships. Requirements - Experience with clinical program design, deployment and/or evaluation in the provider or payer setting. - Experience interacting with leaders across diverse members of the healthcare industry. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase. - 401k contribution (all benefits are subject to eligibility requirements). 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. Company Description 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. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.

• Identify, develop and implement the business strategy for the Medical Affairs and Pharmacovigilance departments • Develop and agree upon annual revenues, sales, profit and operational targets for the Medical Affairs and Pharmacovigilance departments • Evaluate and direct the organization's activities to achieve targets for trading performance, quality, culture and legislative adherence. • Develop and agree upon operating procedures / business processes • Preside as needed over (senior) management team meetings • Maintain and develop organizational culture, values, and reputation • Report to applicable stakeholders on business strategy planning, results and performance for the Medical affairs and Pharmacovigilance department • Act as the organization's representative in its dealings with the outside world • Manage direct reporting staff • Actively contribute to staff learning & development within the company • Monitor and assure client satisfaction on existing projects for the Medical Affairs and Pharmacovigilance department with related activities • Identify key accounts and maintain strong long-lasting relationships to win new and repeat business

Role Description As our Medical Records Professional, you will ensure the integrity, confidentiality, and accessibility of patient health information, meticulously managing records in compliance with all regulatory standards and organizational policies. - Accurately process, retrieve, and maintain patient medical records (electronic and paper). - Manage requests for Protected Health Information (PHI) ensuring strict HIPAA compliance. - Play a key role in ensuring the completeness, accuracy, and proper indexing of health information within the EHR system. - Manage incoming departmental telephone calls and faxes and respond as appropriate. - Maintain accurate physician contact lists. - Perform miscellaneous clerical duties based on departmental needs, such as: - Departmental mail distribution - Filing - Sorting - Copying - Record keeping - Posting - Tabulating information - Organizing assigned tasks - Maintain supply of documentation materials. - Deliver and pick up records, interoffice mail, etc. as needed. - Prepare and mail all outgoing patient correspondence and appropriate attachments. Qualifications - Strong understanding of medical terminology. - Knowledge of health information management principles. - Comprehensive knowledge of HIPAA and privacy regulations. - Meticulous attention to detail. - Strong organizational skills. - Proficiency with EHR systems. Requirements - High School Diploma or GED. - One (1) year clerical experience. - Familiarity with applicable alphabetic and numeric filing systems.