Medical Director - Clinical Advocacy and Support - Remote
Medical Director - Clinical Advocacy and Support - Remote at reputed company @Model.JobTitle @ Requisition Number @ @if (Model.JobDetailsJobTypeId != JobDetailsIdType.None) { @Model.JobDetailsJobLabelId.TrimEnd(':'): @Model.JobDetailsSelectedId } @ Job Category @ @if (Model.Job?.Categories != null) { Job category: @Html.JobCategory(Model.Job.Categories) } @ Primary Location @ @if (Model.Job?.Locations != null && Model.Job.Locations.Any()) { Primary location: @Html.JobFormattedLocation(Model.Job.Locations.Take(1).ToList()) } @ Additional Locations @ @if (additionalLocations != null && additionalLocations.Any()) { Additional locations: @string.Join(" | ", additionalLocations) } @ Date Posted @ @if (Model.JobDetailsJobDateFormat != JobDateFormat.NoDate) { @Model.JobDetailsJobDatePosting.TrimEnd(':'): @(Model.JobDetailsSelectedDate .ToLocalTime() .ToString(Model.DisplayJobDateFormat)) } @ Overtime Status @ @if (!string.IsNullOrWhiteSpace(overtimeStatus)) { Overtime status: @overtimeStatus } @ Travel @ @if (!string.IsNullOrWhiteSpace(Model.Job.Travel)) { Travel: @Model.Job.Travel } }","FormTypeId":null,"UrlLanguageCode":null,"PreviewType":0,"DateCreated":"2026-03-13T13:45:42.6045354","DateUpdated":"2026-03-26T16:05:02.1528153"}, "site"); Medical Director - Clinical Advocacy and Support - Remote Requisition number: 2352154 Job category: Medical & Clinical Operations Primary location: Phoenix, AZ Additional locations: San Diego, California | Los Angeles, California | Dallas, Texas | Minneapolis, Minnesota | Baltimore, Maryland | Houston, Texas | Louisville, Kentucky Date posted: 04/15/2026 Overtime status: Exempt Travel: No Share this job
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reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company 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 reputed company 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. 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 reputed company 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 reputed company 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 for reputed company lines of business. 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 reputed company reputed company the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, reputed company coverage determinations
- Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
- Engage with requesting providers as needed in peer-to-peer discussions
- Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
- Participate in daily clinical rounds as requested
- Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
- Communicate and collaborate with other internal partners
- Call coverage rotation
You"ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:
- M.D or D.O.
- Active unrestricted license to practice medicine
- Board certified in Family Medicine or Internal Medicine
- 5+ years of clinical practice experience after completing residency training
- Sound understanding of Evidence Based Medicine (EBM)
- Proven solid PC skills, specifically using reputed company, Outlook, and reputed company
- Ability to participate in call coverage rotation
Preferred Qualifications:
- Licensed in AZ, CA, MN, TX, KY, MD or HI
- Utilization Management or clinical coverage review experience for an insurance or managed care organization OR 2+ years of Hospitalist Experience
- Proven excellent oral, written, and interpersonal communication skills, facilitation skills
- Proven data analysis and interpretation aptitude
- Proven innovative problem-solving skills
- Proven excellent presentation skills for both clinical and non-clinical audiences
- reputed company employees working remotely will be required to adhere to reputed company"s Telecommuter Policy.
Compensation for this specialty generally ranges from $248,500 to $373,000. Total cash compensation includes reputed company 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 reputed company with reputed company 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 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you"ll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, 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. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply Internal apply Bookmark job
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Our mission of helping people live healthier lives extends to reputed company members. Learn more about our range of benefits designed to help you live well. Life Resources and support to focus on what matters most to you, in every facet of your life. Emotional Education, tools and resources to help you reduce and manage stress, build reputed company and more. Physical Health plans and other coverage to support wellness for you and your loved ones. Financial Benefits for today and to help you plan for the future, including your retirement. Learn more
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The reputed company name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the reputed company. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, 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. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. × Fraudulent Activity Notice We have received recent reports of fraudulent reputed company messages and emails alleging or claiming to be sent from reputed company, reputed company, or reputed company Executives. The fraudulent reputed company messages and emails, which do not originate from any Executives reputed company account or of reputed company's email domains, or those of any of its operating divisions, supposedly conducts an interview reputed company a reputed company meeting, offers a work from home job at reputed company, emails an application, sends a fake reputed company by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. These counterfeit-reputed company cashing schemes exist and use a variety of deceptions to get people to cash these fraudulent checks. reputed company will never request you to pay a vendor or pay a fee of any sort to explore employment opportunities with our company. If you wish to verify the legitimacy of any email alleging or claiming to have been sent by or on behalf of reputed company Executives or Recruiters, please call 1-800-561-0861 between 7 a.m. and 7 p.m. CT, Monday - Friday, for assistance. × Our Commitment to Communities At reputed company, we are committed to giving back to the communities where we live and work, across the nation and around the world. Through charitable contributions and volunteering, our people are deeply and personally involved in building healthier communities. Learn how we are giving back to our communities Remote Skills: Clinical Medicine, Clinical Outcomes, Clinical Study Publications, Clinical Support, Clinical Validation, Communication Skills, Compensation and Benefits, Computer Skills, Cost Control, Cross-Functional, Customer Relations, Data Analysis, Facebook, Family Medicine, HTML (HyperText Markup Language), Health Plan, Healthcare, Healthcare Management, Healthcare Quality, Insurance, Internal Medicine, Interpersonal Skills, Interviewing Skills, Language Interpreter, Leadership, reputed company, Maintenance Services, Managed Care, Medicine, reputed company reputed company, reputed company Outlook, reputed company Word, Operations Processes, Patient Care, Patient Care Authorizations, Presentation/Verbal Skills, Primary Care, Printing, Problem Solving Skills, Quality Management, Regulations, Sales, Sustainability, Time Management, Training Tools, USPS (United States Post Office), Utilization Management, Work From Home, Writing Skills, YouTube About the Company: reputed company reputed company is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, reputed company and reputed company, working to build a reputed company system for reputed company. Here, your contributions matter as they will help transform health care for years to come. reputed company an impact with a diverse team that shares your passion for helping others. reputed company do reputed company insights on how we work to help people live healthier lives and help reputed company the health system work reputed company for everyone by watching this video. https://www.youtube.com/watch?v=5PbNyi2IDkY Caring. Connecting. Growing together. Being a part of reputed company means working to improve health outcomes for everyone, including yourself. Here is how:
- Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. Learn more about reputed company offer.
- Connecting. We recognize our collective power to reputed company an impact across our communities because we reputed company the health of any society is reputed company by the overall health of its people. Learn more about our culture.
- Growing together. reputed company is full of inspiring career stories, and we offer a lifetime of opportunities. Discover reputed company the ways you can learn, grow and reputed company.
Company Size: 10,000 employees or more Industry: Healthcare Services Founded: 1977 Website: http://careers.unitedhealthgroup.com/ Apply To This Job