Medical Director

2 weeks ago

Cypress, United States UnitedHealthcare Full time

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 


Work at home


The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. 


You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.


Primary Responsibilities:

  • Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies
  • Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses
  • Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations
  • Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues
  • Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results
  • Provide clinical and strategic input when participating in organizational committees, projects, and task forces


What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you‘ll open doors for yourself that simply do not exist in any other organization, anywhere.


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 license
  • Board Certified Cardiologist in an ABMS or AOBMS specialty
  • 5+ years clinical practice experience
  • 2+ years Quality Management experience 
  • Intermediate or higher level of proficiency with managed care
  • Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills
  • Proven excellent telephonic communication skills; excellent interpersonal communication skills
  • Proven excellent project management skills
  • Proven data analysis and interpretation skills
  • Proven excellent presentation skills for both clinical and nonclinical audiences. Familiarity with current medical issues and practices
  • Proven creative problem-solving skills
  • Proven solid team player and team building skills


*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy


California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. 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.


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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.


UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

  • Medical Director

    4 weeks ago

    Cypress, Texas, United States Envision Physician Services - Envoy Full time

    Job OverviewWe are seeking a dynamic and experienced Medical Director to lead our team at Bowling Green Hospital. This is a fantastic opportunity for a physician leader to join our esteemed organization, Envision Physician Services - Envoy.

  • Physician Supervisor and Medical Director

    9 hours ago

    Cypress, Texas, United States American Family Care Cypress Full time

    Role DescriptionAs a Physician Supervisor and Medical Director at American Family Care Cypress, you will play a vital role in leading our medical team and ensuring high-quality patient care. Your primary responsibility will be to supervise midlevels working in the practice, ensuring that they adhere to best practices and company policies.Key...

  • Medical Director/Supervising Physician Lead

    2 days ago

    Cypress, Texas, United States American Family Care Cypress Full time

    Job OverviewAmerican Family Care Cypress seeks a highly skilled Medical Director/Supervising Physician to oversee our medical team. As a key member of our leadership team, you will be responsible for directing staff in the support of patient care, providing oversight to advanced practice providers, and actively participating in marketing and representing the...

  • Medical Director Endocrinology Opportunity in Northern Houston

    4 weeks ago

    Cypress, Texas, United States Med Staff Matters Full time

    Endocrinologist Opportunity in Northern HoustonMed Staff Matters is excited to offer a medical director endocrinology opportunity for an experienced endocrinologist to join our team in a new comprehensive care clinic located in a desirable northern Houston suburb.This role presents a unique opportunity to practice medicine in a warm climate, with access to...

  • Medical Director Physician

    3 weeks ago

    Cypress, United States SimplyApply Full time

    Northwest Houston Hospitalist Medical Directorship opportunity. A new hospital employed Hospitalist group is being formed in anticipation of supporting a new hospital being built. The hospital is opening the first quarter of 2025. Candidates must have a minimum of 5 years of leadership experience. Provide clinical care as well as group and program...

  • Supervising Physician and Medical Director

    5 days ago

    Cypress, Texas, United States American Family Care Cypress Full time

    Responsibilities:Act as a supervising physician for midlevels working the practice.Ensure proper follow-up, perform chart review, and ensure adherence to policies.Manage various facets of supervising a busy medical practice, including equipment, supplies, and medications.Compile QA data and address issues with staff providers.Oversee Occupational Health and...

  • Medical Operations Manager

    4 weeks ago

    Cypress, Texas, United States American Family Care Cypress Full time

    Job SummaryA Medical Operations Manager is needed to oversee daily operations at an urgent care clinic. The ideal candidate will possess strong leadership skills and the ability to manage a team of non-physician staff.Key Responsibilities:Recruit, hire, and onboard front office medical receptionists, medical assistants, x-ray technicians, and other support...

  • OR Service Director

    3 weeks ago

    Cypress, Texas, United States Houston Methodist The Woodlands Hospital Full time

    Houston Methodist The Woodlands Hospital Job Description:The OR Service Director - Nursing Leadership Opportunity is a leadership position within the nursing department at Houston Methodist The Woodlands Hospital. As a member of our leadership team, this role will oversee the daily operations of the operating room services, ensuring that patients receive...

  • Nursing Department Director at Houston Methodist

    3 weeks ago

    Cypress, California, United States Houston Methodist The Woodlands Hospital Full time

    Job SummaryWe are seeking a highly skilled and experienced Nursing Department Director to join our team at Houston Methodist The Woodlands Hospital. As a key member of our leadership team, you will be responsible for overseeing the daily operations of our nursing department, ensuring high-quality patient care, and fostering a culture of excellence and...

  • Medical Director

    1 month ago

    Cypress, Texas, United States US Acute Care Solutions Full time

    US Acute Care Solutions: A Leader in Emergency MedicineWe are seeking a highly skilled Emergency Physician to join our team at US Acute Care Solutions. As a leading provider of acute care services, we offer a dynamic and challenging environment that allows our physicians to grow both personally and professionally.About the Role:As an Emergency Physician with...

  • Medical Technologist

    1 month ago

    Cypress, United States HCA Houston Healthcare North Cypress Full time

    Description IntroductionDo you have the career opportunities as a(an) Medical Technologist you want with your current employer? We have an exciting opportunity for you to join HCA Houston Healthcare North Cypress which is part of the nation's leading provider of healthcare services, HCA Healthcare.BenefitsHCA Houston Healthcare North Cypress, offers a total...

  • Director of Total Rewards

    1 week ago

    Cypress, United States Exemplis LLC Full time

    Position Summary:Are you a total rewards wizard who eats comp and benefits for breakfast? Do you thrive on finding that sweet spot where employee happiness and business goals align? We’re looking for a Director of Total Rewards to help us design and deliver the ultimate rewards package that keeps our people happy, satisfied, engaged, and occasionally...

  • Medical Laboratory Scientist

    3 weeks ago

    Cypress, United States Houston Methodist Cypress Hospital Full time

    At Houston Methodist, the Medical Laboratory Scientist position is responsible for performing both routine and complex analyses, which necessitates knowledge of laboratory techniques, principles, and equipment and their interrelationship. This position exercises good judgment by using critical thinking skills and deals with issue resolution concerning the...

  • Medical Laboratory Scientist

    1 week ago

    Cypress, United States Houston Methodist Cypress Hospital Full time

    Job DescriptionAt Houston Methodist, the Medical Laboratory Scientist position is responsible for performing both routine and complex analyses, which necessitates knowledge of laboratory techniques, principles, and equipment and their interrelationship. This position exercises good judgment by using critical thinking skills and deals with issue resolution...

  • Medical Laboratory Scientist

    4 weeks ago

    Cypress, United States Houston Methodist Cypress Hospital Full time

    At Houston Methodist, the Medical Laboratory Scientist position is responsible for performing both routine and complex analyses, which necessitates knowledge of laboratory techniques, principles, and equipment and their interrelationship. This position exercises good judgment by using critical thinking skills and deals with issue resolution concerning the...

  • Medical Laboratory Scientist

    2 months ago

    Cypress, United States Houston Methodist Cypress Hospital Full time

    At Houston Methodist, the Medical Laboratory Scientist position is responsible for performing both routine and complex analyses, which necessitates knowledge of laboratory techniques, principles, and equipment and their interrelationship. This position exercises good judgment by using critical thinking skills and deals with issue resolution concerning the...

  • Medical Laboratory Scientist

    4 weeks ago

    Cypress, United States Houston Methodist Cypress Hospital Full time

    At Houston Methodist, the Medical Laboratory Scientist position is responsible for performing both routine and complex analyses, which necessitates knowledge of laboratory techniques, principles, and equipment and their interrelationship. This position exercises good judgment by using critical thinking skills and deals with issue resolution concerning the...

  • Medical Laboratory Scientist

    2 months ago

    Cypress, United States Houston Methodist Cypress Hospital Full time

    At Houston Methodist, the Medical Laboratory Scientist position is responsible for performing both routine and complex analyses, which necessitates knowledge of laboratory techniques, principles, and equipment and their interrelationship. This position exercises good judgment by using critical thinking skills and deals with issue resolution concerning the...

  • Medical Laboratory Scientist

    4 weeks ago

    Cypress, United States Houston Methodist Cypress Hospital Full time

    At Houston Methodist, the Medical Laboratory Scientist position is responsible for performing both routine and complex analyses, which necessitates knowledge of laboratory techniques, principles, and equipment and their interrelationship. This position exercises good judgment by using critical thinking skills and deals with issue resolution concerning the...

  • Medical Laboratory Scientist

    1 month ago

    Cypress, United States Houston Methodist Cypress Hospital Full time

    At Houston Methodist, the Medical Laboratory Scientist position is responsible for performing both routine and complex analyses, which necessitates knowledge of laboratory techniques, principles, and equipment and their interrelationship. This position exercises good judgment by using critical thinking skills and deals with issue resolution concerning the...