Medical Director - Vascular Surgery

Responsibilities

• Conduct coverage reviews based on individual member plan benefits and national or proprietary policies to render coverage determinations
• Document clinical review findings, actions, and outcomes in accordance with regulatory and accreditation requirements
• Engage with requesting providers through peer-to-peer discussions as needed
• Interpret existing benefit language and policies during the clinical coverage review process
• Communicate and collaborate with network and non-network providers to ensure accurate and timely benefit determinations
• Participate in daily clinical rounds and call coverage rotations

Requirements

• M.D. or D.O. degree
• Board certification in General Surgery (ABMS or AOA) with specific experience in Vascular Surgery
• Active, unrestricted medical license to practice medicine
• 5+ years of clinical practice experience following the completion of residency training
• Sound understanding of Evidence Based Medicine (EBM)
• Experience performing vascular surgeries and procedures
• Proficiency in MS Office (Word, Outlook, and Excel)
• Ability and willingness to participate in call coverage rotation

Preferred Qualifications

• Experience in utilization management and clinical coverage review
• Excellent oral, written, and interpersonal communication skills
• Proven aptitude for data analysis and interpretation
• Strong innovative problem-solving skills
• Ability to communicate effectively with both clinical and non-clinical audiences

Benefits

• Comprehensive health plans and coverage for you and your loved ones
• Retirement planning tools and 401k contributions
• Incentive and recognition programs
• Equity stock purchase options
• Flexible remote work environment

About the Company

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. We connect people with the care, pharmacy benefits, data, and resources they need to feel their best. At Optum, you will find a culture guided by inclusion, talented peers, and continuous career development opportunities.