Medical Director - Vascular Surgery - Remote

Primary Responsibilities

• Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
• Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
• Engage with requesting providers as needed in peer-to-peer discussions
• Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
• Participate in daily clinical rounds as requested
• Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
• Communicate and collaborate with other internal partners
• Call coverage rotation

Required Qualifications

• M.D. or D.O., Board certification in General Surgery through the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) with experience in Vascular Surgery
• Active unrestricted license to practice medicine
• 5+ years of clinical practice experience after completing residency training
• Sound understanding of Evidence Based Medicine (EBM)
• Experience performing vascular surgeries and procedures
• Solid PC skills, specifically using MS Word, Outlook, and Excel
• Ability and willingness to participate in call coverage rotation

Preferred Qualifications

• Experience in utilization and clinical coverage review
• Proven excellent oral, written, and interpersonal communication skills, facilitation skills
• Proven data analysis and interpretation aptitude
• Proven innovative problem-solving skills
• Proven excellent skills for both clinical and non-clinical audiences

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Pay

The salary for this role will range from $248,500 - $373,000 annually based on full-time employment.

Schedule

Candidates are required to pass a drug test before beginning employment.

Contact Information

Join us to start Caring. Connecting. Growing together. For more information about this position, please visit UnitedHealth Group Careers.