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Medical Oncology Director
1 month ago
Job Summary: We are seeking an experienced Medical Director Medical Oncology to join our team at UnitedHealth Group. In this role, you will play a critical part in improving health outcomes by providing utilization review determinations and supporting case and disease management teams to achieve optimal clinical outcomes.
The ideal candidate will have a strong background in clinical practice and experience working with medical care delivery systems, utilization management, case management, disease management, quality management, product development, and/or peer review. You will also have excellent interpersonal skills and the ability to work over the telephone with other colleagues including physicians, nurses, PTs, OTs, and other similar personnel.
Key Responsibilities:
- Provide 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).
- Engage and collaborate with treating providers telephonically to discuss evidence-based guidelines, opportunities to close clinical quality/service gaps, and care plan changes that can impact healthcare expense.
- Enhance clinical expertise of the Oncology team through education sessions with nursing teams and serve 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.
- Participate in rotational call coverage for weekends and holidays.
