UHG

About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Medical and Clinical Operations

Country:

United States

Postal Code:

92101

Approximate Salary:

Not Specified

Position Type:

Full Time

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Physician Advisor - Correctional- San Diego Sherrif's Ops Center - Part Time

UHG - San Diego, California

Posted: 09/30/2018

This role will be in the San Diego Operations Center. 20 Hours a week-Flexible days-No Nights or Weekends.
 
A duly licensed physician authorized to practice in the State of California who under the direction of the Sheriff's Department Chief Medical Officer (CMO) shall perform the following:
  • Comply and maintain the current Sheriff's Managed Care Group operational process and workflow
  • Utilize a UR system (InterQual) tied to current Sheriff's Electronic Medical Record (EMR) system utilizing standard objective criteria
  • Perform utilization reviews on all cases in the UR process
  • Creation of utilization reports capturing metrics related to the covered lives
  • Creation of financial reports characterizing the fiscal impact related to the Managed Care programs
  •  Facilitation of inter-facility transfer process
  •  Ensure legal and regulatory compliance
  •  Provide direction to other MCG staff
  
Positions in this function are MDs and other clinical professionals who consult on various processes The function includes roles which manage development and implementation of medical expense management initiatives.
 
Primary Responsibilities:
  • Advises leadership on improvement opportunities regarding medical expense programs and clinical activities that impact medical expense
  • Company thought leader
  • Functional SME
  • Broad business approach
  • Resource to senior leadership
  • Develops pioneering approaches to emerging industry trends

Required Qualifications:
  • Active, Unrestricted Licensed physician in CA
  • 5+ years clinical practice experience
  • Supervisory skills, including clinical mentoring and coaching expertise
  • Excellent presentation skills for both clinical and nonclinical audiences
  • Excellent interpersonal communication skills (telephonic and face to face)
  • The ability to establish rapport with physicians in peer to peer communications in frequent daily calls to physicians and facilities regarding perceived gaps in EBM and problem solving to close those gaps
  • Data analysis and interpretation experience and skills
  • Strong belief in EBM philosophy
  • Creative problem solving skills
  • Strong team player with team building skills
  • Comfortable with change, and able to lead others through it
 
Preferred Qualifications:
  • Training in Six Sigma methodology
  • Correctional medicine experience
 
Careers at UnitedHealth Group. We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these select few, we offer the global reach, resources and can-do culture of a Fortune 6 company. We provide an environment where you're empowered to be your best. We encourage you to take risks. And we offer a world of rewards and benefits for performance. We believe the most important is the opportunity to do your life's best work.(sm)
 
 
 
 
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
 
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    
  
Job Keywords:  clinical, Physician, EBM, Six Sigma, correctional medicine, San Diego, CA, California, Medical Director

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