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Medical Director Prior-Authorization
Medical Director Prior-Authorization-November 2024
Seattle
Nov 27, 2024
ABOUT UNITEDHEALTH GROUP
With offices around the world, UnitedHealth Group's headquarters are located in the Minneapolis metropolitan area.
10,000+ employees
Healthcare
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About Medical Director Prior-Authorization

  Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

  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.

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

  Primary Responsibilities:

  Work to improve quality and promote evidence-based medicine Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement Support initiatives that enhance quality throughout our national network Ensure the right service is provided at the right time for each member Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review We are a small organization in AZ that is given a lot of freedom on how we run things. Medical Director-led with the opportunity to innovate and we don't have red tape layers backed by UHG. Great culture and resources. Success in this technology-heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production-driven setting.

  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 degree Active, unrestricted physician state license Current board certification in ABMS or AOA specialty 5+ years of clinical practice experience post residency Strong understanding of and concurrence with evidence-based medicine (EBM) and managed care principles

  Preferred Qualifications:

  Hands-on utilization and/or quality management experience Project management or active project participation experience Substantial experience in using electronic clinical systems

  If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years.

  This position will support the growing Prior Auth program which covers the New Mexico, Utah, Nevada, and Arizona Markets. The scope of this role will include Prior Authorization for Medicare Advantage members focusing on high value procedures such as Myocardial SPECT, PET scans, DME/Home Ventilator, Genetic Testing, and many more. Additionally, the team handles UM functions for the Arizona and New Mexico markets.

  Nationwide Telecommute Residents Only: The salary range for Telecommute residents is $248,582 to $338,965 per year. 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 education, work experience, certifications, etc. 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.

  Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employers 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.

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