Job Summary
The Medical Director is responsible for overseeing clinical coverage evaluations and making determinations regarding medical necessity in accordance with benefit plans and established national guidelines. This role involves working closely with various teams and healthcare providers to promote the provision of efficient and high-quality medical care.
Responsibilities
- Conduct clinical coverage reviews and assess medical necessity based on relevant policies.
- Collaborate effectively with multidisciplinary teams and healthcare providers.
- Ensure the delivery of cost-effective and high-quality medical services.
Qualifications
- Active and unrestricted M.D. or D.O. license.
- Board certification from the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA).
- A minimum of 3 years of clinical practice experience after completing residency, with a preference for candidates from surgical specialties.
UnitedHealth Group provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
