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Job Description
Join Optum as a Medical Director in Otolaryngology, working remotely to improve health outcomes through clinical support. Collaborate with a multidisciplinary team to ensure quality medical care for members and manage benefit coverage determinations.
Key Responsibilities
Conduct coverage reviews based on individual member plan benefits
Document clinical review findings, actions, and outcomes
Engage with requesting providers in peer-to-peer discussions
Interpret existing benefit language and policies in coverage reviews
Participate in daily clinical rounds as requested
Communicate and collaborate with network and non-network providers
Call coverage rotation
Required Qualifications
M.D or D.O.
Board certification in Otolaryngology (ENT)
Active unrestricted license to practice medicine
5+ years of clinical practice experience after completing residency training
Sound understanding of Evidence Based Medicine (EBM)
Solid PC skills, specifically using MS Word, Outlook, and Excel
Proven ability to participate in call coverage rotation
Preferred Qualifications
Experience in utilization and clinical coverage review
Proven excellent oral, written, and interpersonal communication skills
Proven data analysis and interpretation aptitude
Proven innovative problem-solving skills
Proven excellent skills for both clinical and non-clinical audiences
Reside in either MST or PST zone or willing to work those hours
Benefits & Perks
Comprehensive benefits packageIncentive and recognition programsEquity stock purchase401k contribution