Family Practice Full-Time position in Irvine, California
5 days ago
Caring. Connecting. Growing together.
Want to make a real difference in the lives you touch?
LOOK NO FURTHER.
Optum is a physician-led, close-knit team that has been long-respected in Southern California. We are passionate about patients. We are leading the state of California toward better healthcare practices. And we are looking for amazing doctors like you.
As part of our continued growth, Optum is looking for
Medical Director to join our regional team in Orange County.
Position Highlights:
- Office Schedule: Monday - Friday
- Provides medical leadership and physician advice to the quality management area with respect to quality improvement studies, quality improvement committees, primary care assessments (both office-site assessments and medical record document reviews)
- Provides medical expertise for traditional utilization management services and resources for outpatient medical, surgical, and pharmacy activity
- Perform medical reviews and determinations (i.e., brief written criteria/reasons for determination) of Utilization Management and Pharmacy, prior authorizations, concurrent, retrospective authorizations, grievances, and gap appeals
- Lead regional special projects under direction of Regional CMO
- Participate and provide physician advice to Medical Management interdisciplinary care teams that are inclusive of nurses, physicians, social works, care coordinators, and pharmacists
- Educate and communicates with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization, and effective resource management
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 and unrestricted MD or DO license in California
- Board certification in their chosen specialty
- 5+ years of clinical practice experience
- 2+ years of experience working in a managed care setting
- 2+ years of experience in utilization management, utilization review and prior authorization
- Experience working with clinical information technology systems
- Proficiency working with data analytics, reporting and presentations
- Proven excellent communication and time management skills
- Proven comfortable presenting in group setting
California Residents Only: The salary range for this role is $286,104 to $397,743 annually. 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 local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
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