Utilization Management Medical Director - Medical Oncology - Remote anywhere in US

Primary Responsibilities

• Perform utilization review determinations for oncology populations, and support case and disease management teams to achieve optimal clinical outcomes
• Serve as a subject matter expert in evidence-based oncology guidelines, especially those produced by the National Comprehensive Cancer Network (NCCN), and help ensure all clinically relevant policies and processes are informed by the best available evidence
• Engage and collaborate with treating providers telephonically; This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense
• Enhance clinical expertise of the Oncology team through education sessions with nursing teams, and serving as a thought leader and point of contact for relevant medical societies and stakeholders
• Evaluate clinical and other data (e.g., quality metrics, claims and health record data, utilization data) to identify opportunities for improvement of clinical care and processes
• Collaborate with operational and business partners on enterprise-wide research and clinical and quality initiatives to enhance Optum impact in the oncology field

Required Qualifications

• MD or DO with an active, unrestricted medical license
• Obtain additional licenses as needed
• Current Board Certification in an ABMS or AOBMS specialty in Oncology
• 5+ years of clinical practice experience (inclusive of Medical Oncology)
• Experience working with NCCN guidelines
• Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development, and/or peer review
• Proven ability to participate in rotational holiday and call coverage

Preferred Qualification

• Experience in managed care and quality management

Compensation

Compensation for this specialty generally ranges from $248,500.00 to $373,000.00. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role.

Benefits

We offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).