Utilization Management Medical Director, Clinical Performance - California license - Remote
Optum
San Jose, CA
1 day ago
$238,000 - $357,500
Job Description
Join Optum as a Utilization Management Medical Director and lead efforts to improve health outcomes through evidence-based medicine and effective utilization management in California. Enjoy remote flexibility while making a significant impact on patient care.
Key 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
Required Qualifications
MD or DO degree
Active, unrestricted California state license
Current board certification in ABMS or AOA specialty
5+ years of clinical practice experience post residency
Solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles