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.
This position will serve as the medical director for EBM Connect quality measures and Impact Pro as well as provide clinical consultation for other products when needed. A Medical Director on the Advanced Analytics and Clinical Insights team provides clinical expertise, including the development and review of claims-based code sets (e.g., ICD-10, CPT, LOINC) and supports clinical decision-making logic within a suite of software products.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Act as the EBM Connect medical director, providing clinical expertise to support, enhance, and develop quality measures Provide clinical oversight and leadership for Impact Pro Present clinical methods and act as product clinical subject matter expert as necessary for client interactions Coordinate an outside panel of physicians that assist with development and maintenance of quality measures Work at a detailed level with codes (e.g., ICD-10, CPT) and pharmacy claims to determine clinical definitions used to support analytics and consulting projects Promote a culture of clinical excellence for the company and its analytic- and quality-based solutions Lead or contribute to efforts to write peer-reviewed publications, white papers, and other dissemination projects that highlight the use of our analytic solutions
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 with an active, unrestricted license 2+ years of experience as a practicing physician in the United States 2+ years of experience in the use and application of claims-based analytics Experience with quality measures Demonstrated ability in written and verbal communication and presentation skills Familiarity with administrative claims data and medical coding systems (i.e., CPT, HCPCS, ICD-10) Proven solid interpersonal skills and ability to work cohesively in a team environment Proven solid organizational skills (e.g., prioritize and manage multiple tasks, meet deadlines, complete complex long-term projects)
Preferred Qualifications:
Board certified in an ABMS or AOBMS specialty Certification in Medical Informatics Experience with, or direct use of, any tool within Symmetry Suite or Impact Suite analytic applications Experience with machine learning Published in peer-reviewed journals Experience with risk-adjusted quality measures and payment tools Experience with clinical data from EMR Demonstrated ability to develop new analytics to meet market needs Recent knowledge and/or experience in cost/utilization measurement, bundled payments, or episode groupers Recent knowledge and/or experience in national quality measure organizations (e.g., STARS, HEDIS, State measures) Proven basic skills using industry-standard data analysis tools such as Microsoft ACCESS, EXCEL, or SQL
California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington residents is $248,582 to $338,965 per ear. 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.
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
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 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