Medical Director
4 weeks ago
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. Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs. The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services. The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member’s primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements Engage with requesting providers as needed in peer-to-peer discussions Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews Participate in daily clinical rounds as requested Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy Communicate and collaborate with other internal partners Call coverage rotation 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: M.D or D.O. Active unrestricted license to practice medicine Board certification in an ABMS specialty with Hematology - Oncology, General Surgery, Rheumatology, Internal Medicine, or PM&R preferred. 5 years of clinical practice experience after completing residency training Sound understanding of Evidence Based Medicine (EBM) Solid PC skills, specifically using MS Word, Outlook, and Excel Preferred Qualifications: CA, OR, WA or AZ licensure or willing to obtain Experience in utilization and clinical coverage review Proven excellent oral, written, and interpersonal communication skills, facilitation skills Proven data analysis and interpretation aptitude Proven innovative problem-solving skills Proven excellent presentation skills for both clinical and non-clinical audiences All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy. California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $286,104 to $397,743 per year . S alary 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.
-
Regional Medical Director
2 weeks ago
San Diego, United States AmeriVet Veterinary Partners Full timeRegional Medical Director Position Summary: AmeriVet Veterinary Partners is currently looking for Regional Medical Directors to support our West Coast Market. The Veterinary Regional Medical Director (RMD) is responsible for aligning AmeriVet's strategic plan and objectives with veterinary practice excellence within the assigned region. The RMD oversees the...
-
Hospice Medical Director
1 month ago
San Diego, United States VITAS Healthcare Full timeABOUT USVITAS Healthcare is the nation s leading provider of end-of-life care, and has the resources and expertise to support your personal and professional growth. As a member of the VITAS team, you ll find fulfillment working for a people-focused organization dedicated to making a difference in the lives of others. You will be more than just an employee:...
-
Regional Medical Director
7 days ago
San Diego, United States AmeriVet Veterinary Partners Full timeRegional Medical DirectorPosition Summary:AmeriVet Veterinary Partners is currently looking for Regional Medical Directors to support our West Coast Market. The Veterinary Regional Medical Director (RMD) is responsible for aligning AmeriVet's strategic plan and objectives with veterinary practice excellence within the assigned region. The RMD oversees the...
-
Regional Medical Director
2 months ago
San Diego, United States Amerivet Services LLC Full timePosition Summary: AmeriVet Veterinary Partners is currently looking for Regional Medical Directors to support our West Coast Market. The Veterinary Regional Medical Director (RMD) is responsible for aligning AmeriVet's strategic plan and objectives with veterinary practice excellence within the assigned region. The RMD oversees the training, organization,...
-
Study Director
3 months ago
San Diego, United States Pharmaron Full timeJob DescriptionJob DescriptionAre you ready to embark on an exhilarating journey with a team that's passionate about making a difference? Look no further - Pharmaron is thrilled to invite you to join us as our newest Principal Scientist / Study Director in our Medical Device team! If you're craving a role that offers challenges, growth, and...
-
Medical Director
4 days ago
San Diego, California, United States Family Health Centers of San Diego Full timeJob SummaryWe are seeking a highly experienced and skilled Medical Director to lead our clinical research efforts at Family Health Centers of San Diego. The successful candidate will have a strong background in clinical research, leadership, and management, with a proven track record of securing research funding and grants.Key ResponsibilitiesLeadership and...
-
Senior Medical Director Consultant
2 weeks ago
San Diego, United States Meet Full timeWe are seeking a Senior Medical Director with expertise in respiratory diseases for a 20-hour per week consultancy role. Reporting to the Chief Medical Officer, this position involves supporting clinical leadership and ensuring the successful design and implementation of Clinical Development Plans. While experience in cystic fibrosis is preferred, it is not...
-
Senior Medical Director Consultant
7 hours ago
San Diego, United States Meet Recruitment Inc. Full timeWe are seeking a Senior Medical Director with expertise in respiratory diseases for a 20-hour per week consultancy role. Reporting to the Chief Medical Officer, this position involves supporting clinical leadership and ensuring the successful design and implementation of Clinical Development Plans. While experience in cystic fibrosis is preferred, it is not...
-
Executive Medical Director, Psychiatry
1 day ago
San Diego, California, United States Neurocrine Biosciences Full timeAbout the RoleThe Executive Director of Medical Affairs will lead the planning and execution of all medical strategies for Ingrezza and the broader psychiatry portfolio, aligning with business goals and market needs.Key ResponsibilitiesCollect and synthesize insights from external stakeholders to understand education and data needs of providers, payers,...
-
Cancer Center Director
1 week ago
San Diego, United States Sanford Burnham Prebys Medical Discovery Institute Full timeJob DescriptionJob DescriptionSanford Burnham Prebys is a preeminent, independent biomedical research institute dedicated to understanding human biology and disease, and advancing scientific discoveries to profoundly impact human health.The Cancer Center at Sanford Burnham Prebys Medical Discovery Institute in La Jolla, California, is an internationally...
-
Director of Regulatory Compliance
1 day ago
San Diego, California, United States Modular Medical Inc Full timeJob Description**Job Title:** Director of Regulatory Affairs**Job Category:** Exempt**Department:** R&D**Direct Report:** N/A**Location:** N/A**Travel Required:** N/A**Salary Range:** N/A**Position Type:** Full-time/OnsiteJob SummaryModular Medical Inc is seeking a highly experienced Director of Regulatory Affairs to lead our regulatory strategy and ensure...
-
Regulatory Affairs Director
1 day ago
San Diego, California, United States Modular Medical Inc Full timeJob Description**Job Title:** Director of Regulatory Affairs**Job Category:** Exempt**Department:** R&D**Direct Report:** N/A**Location:** N/A**Travel Required:** N/A**Salary Range:** N/A**Position Type:** Full-time/OnsiteJob SummaryModular Medical Inc is seeking a highly experienced Director of Regulatory Affairs to lead our regulatory strategy and ensure...
-
Hospice Medical Director
1 month ago
San Diego, CA, United States VITAS Healthcare Full timeABOUT USVITAS Healthcare is the nation s leading provider of end-of-life care, and has the resources and expertise to support your personal and professional growth. As a member of the VITAS team, you ll find fulfillment working for a people-focused organization dedicated to making a difference in the lives of others. You will be more than just an employee:...
-
San Diego, California, United States Acadia Pharmaceuticals Inc. Full timeAbout the RoleWe are seeking a highly experienced and skilled Senior Director of Pharmacovigilance and Medical Safety to join our team at Acadia Pharmaceuticals Inc. This is a critical role that will play a key part in ensuring the safety of our products and maintaining the trust of our stakeholders.Key ResponsibilitiesDevelop and Implement Safety...
-
San Diego, California, United States Acadia Pharmaceuticals Inc. Full timeAbout the RoleWe are seeking a highly experienced and skilled Senior Director of Pharmacovigilance and Medical Safety to join our team at Acadia Pharmaceuticals Inc. This is a critical role that will play a key part in ensuring the safety of our products and maintaining the trust of our stakeholders.Key ResponsibilitiesDevelop and Implement Safety...
-
Culinary Director
2 months ago
San Diego, United States Independent Restaurant Group Full timeA small independent restaurant group with varied concepts is bringing on board a Culinary Director to improve systems and implement new menu components. The group prides itself on building connections, not only with guests, but the team as well. Looking for an individual that can both help elevate the food while refining existing infrastructure!Culinary...
-
Culinary Director
2 months ago
San Diego, United States Independent Restaurant Group Full timeA small independent restaurant group with varied concepts is bringing on board a Culinary Director to improve systems and implement new menu components. The group prides itself on building connections, not only with guests, but the team as well. Looking for an individual that can both help elevate the food while refining existing infrastructure!Culinary...
-
Program Director
9 hours ago
San Diego, United States PFC Fitness Camp Full timeJoin to apply for the Program Director role at PFC Fitness Camp.Program director is responsible for overseeing all departments (behavioral health, culinary, nutrition, fitness, operations) and onsite operations including HR - hire, train, evaluate, terminate; provide leadership and vision for all aspects of programming, staff development, and operational...
-
Program Director
4 hours ago
San Diego, United States PFC Fitness Camp Full timeJoin to apply for the Program Director role at PFC Fitness Camp.Program director is responsible for overseeing all departments (behavioral health, culinary, nutrition, fitness, operations) and onsite operations including HR - hire, train, evaluate, terminate; provide leadership and vision for all aspects of programming, staff development, and operational...
-
Store Director
6 days ago
San Diego, California, United States Windsor Fashions Full timeJob DescriptionAbout the RoleWe are seeking a highly skilled and experienced Store Director to join our team at Windsor Fashions. As a Store Director, you will be responsible for driving the success of our store by leading a team of fashion-loving professionals and delivering exceptional customer experiences.Key ResponsibilitiesLead and manage a team of up...
