UM Medical Director

Radiation Oncology Medical DirectorOptum 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 5 industry leader.

The radiation oncology medical director provides clinical leadership and specialty expertise in support of the Cancer Guidance Program (CGP) within Enterprise Clinical Services. In this role, you will apply your radiation oncology expertise to clinical coverage and medical necessity reviews, helping support high quality, evidence based and appropriate cancer care.

Working as part of a multidisciplinary clinical team, you will review radiation oncology treatment requests, make coverage determinations in accordance with applicable benefits, clinical policies and evidence based criteria, and engage treating physicians in peer to peer discussions when needed. You will also contribute clinical expertise to the continued quality, consistency and effectiveness of the Cancer Guidance Program.

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

Primary

Responsibilities:

Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomesServe as a subject matter expert in evidence-based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidenceEngage and collaborate with treating providers telephonically; This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expenseEnhance 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 stakeholdersEvaluate clinical and other data (e.g., quality metrics, claims and health record data, utilization data) to identify opportunities for improvement of clinical care and processesCollaborate with operational and business partners on enterprise-wide research and clinical and quality initiatives to enhance Optum impact in the oncology fieldYou'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 degreeActive, unrestricted physician state licenseCurrent board certification in Radiation Oncology5+ years of clinical practice experience post residencySolid understanding of and concurrence with evidence-based medicine (EBM) and managed care principlesPreferred

Qualifications:
Hands-on utilization and/or quality management experienceProject management or active project participation experienceSubstantial experience in using electronic clinical systemsPay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary,

we offer
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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $248,500
- $373,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

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