Stryker Corporation logo

Clinical Review Medical Director - Neurology - Remote

$249k-373k/hrFull-timeRemote

location_on2173;2189, Washington Street, Nubian Square, Roxbury, Boston, Suffolk County, Massachusetts, 02119, United States

Apply Now

Job Description

About Optum

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.️ Connecting️ Growing together.

About the Role

Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.

The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director’s activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre‑service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non‑network physicians, as well as other Enterprise Clinical Services.

The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits. The collaboration often involves the member’s primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost‑effective quality medical care is provided to members.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Compensation and Benefits

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. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far‑reaching choice of benefits and incentives.

Equal Opportunity and Workplace Policy

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.

All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Work location

Work model: Remote

2173;2189, Washington Street, Nubian Square, Roxbury, Boston, Suffolk County, Massachusetts, 02119, United States

Boston, Massachusetts

Open in Google Maps(42.33144, -71.08274)

Key Responsibilities

  • check_circleConduct coverage reviews based on member plan benefits and proprietary policies
  • check_circleRender coverage determinations and document clinical review findings
  • check_circleInterpret benefit language and policies for clinical coverage reviews
  • check_circleParticipate in daily clinical rounds as requested
  • check_circleCollaborate with internal partners
  • check_circleCollaborate with network and non-network providers for benefit determinations
  • check_circleEngage in peer-to-peer discussions with requesting providers
  • check_circleEducate providers on benefit plans and medical policy

Requirements

  • verifiedM.D or D.O.
  • verifiedActive unrestricted license to practice medicine
  • verifiedBoard Certification in Neurology through ABMS or AOA
  • verified5+ years clinical practice after residency
  • verifiedSound understanding of Evidence Based Medicine
  • verifiedMS Word, Outlook, and Excel

Benefits & Perks

check_circleIn

Similar Job Opportunities

Frequently asked questions about Clinical Review Medical Director - Neurology - Remote at Stryker Corporation

What does a Clinical Review Medical Director - Neurology - Remote at Stryker Corporation do?expand_more
A Clinical Review Medical Director - Neurology - Remote at Stryker Corporation is responsible for the following: Conduct coverage reviews based on member plan benefits and proprietary policies; Render coverage determinations and document clinical review findings; Interpret benefit language and policies for clinical coverage reviews; and Participate in daily clinical rounds as requested.
What are the requirements for this Clinical Review Medical Director - Neurology - Remote role?expand_more
Stryker Corporation is looking for candidates who meet the following requirements: M.D or D.O.; Active unrestricted license to practice medicine; Board Certification in Neurology through ABMS or AOA; 5+ years clinical practice after residency; Sound understanding of Evidence Based Medicine; and MS Word, Outlook, and Excel.
What is the salary range for Clinical Review Medical Director - Neurology - Remote at Stryker Corporation?expand_more
The advertised salary range for Clinical Review Medical Director - Neurology - Remote at Stryker Corporation is $249k-373k/hr.
Where is the Clinical Review Medical Director - Neurology - Remote role at Stryker Corporation located?expand_more
Clinical Review Medical Director - Neurology - Remote at Stryker Corporation is based in 2173;2189, Washington Street, Nubian Square, Roxbury, Boston, Suffolk County, Massachusetts, 02119, United States. This is a remote role.
Is this Clinical Review Medical Director - Neurology - Remote job remote, hybrid, or on-site?expand_more
Stryker Corporation has listed this Clinical Review Medical Director - Neurology - Remote role as remote.
How much experience is required for this Clinical Review Medical Director - Neurology - Remote role?expand_more
Clinical Review Medical Director - Neurology - Remote at Stryker Corporation typically requires 5+ years of relevant experience at the senior level.
What skills do you need for the Clinical Review Medical Director - Neurology - Remote role at Stryker Corporation?expand_more
Key skills for Clinical Review Medical Director - Neurology - Remote at Stryker Corporation include ms word; outlook; excel; do; american board of medical specialties; american osteopathic association; evidence based medicine; and data analysis.
What category does the Clinical Review Medical Director - Neurology - Remote role belong to?expand_more
Clinical Review Medical Director - Neurology - Remote at Stryker Corporation is part of the Healthcare & Nursing job category on Recrutus.