Medical Director Oncology Specialist

2 weeks ago

TX United States UnitedHealth Group Full time
Optum Medical Director Medical Oncology Job Description

At Optum, we strive to deliver care that improves health outcomes for millions of people worldwide. As a Medical Director Medical Oncology, you will play a crucial role in connecting people with the care, pharmacy benefits, data, and resources they need to live healthier lives.

Key Responsibilities:

  • Provide utilization review determinations and support case and disease management teams to achieve optimal clinical outcomes.
  • Serve as a subject matter expert in evidence-based oncology guidelines, particularly those produced by the National Comprehensive Cancer Network (NCCN), and ensure that all clinically relevant policies and processes are informed by the best available evidence.
  • Engage and collaborate with treating providers telephonically, discussing 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 serving 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's impact in the oncology field.
  • Participate in rotational call coverage for weekends and holidays.

Requirements:

  • MD or DO with an active, unrestricted medical license.
  • Current Board Certification in an ABMS or AOBMS specialty in Medical Oncology.
  • 5+ years of clinical practice experience (inclusive of Medical Oncology).
  • Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development, and/or peer review.
  • Computer skills: able to navigate in a Windows-based environment to include Microsoft Office Suite, Edge browser, and Teams.
  • Excellent interpersonal skills and the ability to work over the telephone with other colleagues, including physicians, nurses, PTs, OTs, and other similar personnel.
  • Participate in rotational call coverage for weekends and holidays.

Preferred Qualification:

  • Experience working with NCCN guidelines.

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.

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