National Medical Director of Orthopedic and Musculoskeletal Programs NEW

Remote, Oregon
Optum

UnitedHealthcare is seeking a National Medical Director of Orthopedic and Musculoskeletal Programs to lead the design, development, and oversight of clinical specialty programs. This role focuses on improving the affordability and quality of medical care across musculoskeletal procedures, therapies, implantable hardware, and DME. The director will lead an entrepreneurial team, utilizing analytical tools, medical literature, and clinical experience to implement clinical programs that lower costs, simplify healthcare delivery, and enhance quality and outcomes.

Practice Info

• Reports to the National Medical Director of Specialty Content and Care Pathways in UnitedHealthcare Clinical Services
• Leads a small entrepreneurial team
• Work remotely from anywhere within the U.S.
• For hires within 30 minutes of an office in Minnesota or Washington, D.C., required to work a minimum of four days per week in-office

Responsibilities

• Oversee the strategy for health plan musculoskeletal specialty programs using knowledge of the healthcare industry, emerging technology, and medical specialty guidelines
• Lead the design of clinical program development for modernizing utilization management and retrospective clinical review programs across the continuum of musculoskeletal procedures
• Provide leadership and clinical insights for musculoskeletal category activities across the enterprise such as value-based care programs and quality improvement initiatives
• Identify pain points in current prior authorization processes and propose innovative solutions
• Assess and interpret complex financial and clinical data to evaluate feasibility of proposed initiatives
• Direct the healthcare analytics team as they work through hypothesis and problems and synthesize the results
• Articulate and represent UHC clinical strategy to executive leaders across the enterprise and to external stakeholders
• Collaborate with the CMO, clinical, network and business leaders on top priorities and goals

Compensation

• The salary for this role will range from $386,500 to $579,500 annually based on full-time employment
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Benefits

• A comprehensive benefits package

Requirements

• Doctorate of Medicine (MD or DO) degree with active/unrestricted medical license in one of more states
• Board certified in Orthopedics or related specialty required
• 10+ years of clinical practice experience required
• 7+ years of progressive healthcare leadership experience managing clinical and cross functional teams
• 5+ years of senior level management experience leading clinical operations in a health plan or managed care environment
• Business training and experience in addition to clinical expertise
• Demonstrated understanding of and experience with managed care functions of utilization management, clinical decision support, post service review, and/or care management functions aligned to evidence-based medicine
• Demonstrated ability to read and understand evidence-based medical literature and how this applies to the development of medical policy and clinical guidelines
• Familiarity with digital health platforms and healthcare data exchange
• Experience in digital health transformation or technology-enabled care models (preferred)