Director Training, Optum Physician Advisor and Utilization Management Services - Remote

Job d:

Location:

Charlotte, North Carolina, United States Salary: $134,600 - $230,800/year

Job Area:
Business Operations Company:
United Health Group 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  this leadership role, you will oversee a critical training and quality organization supporting utilization management operations across a large, geographically dispersed healthcare environment. Leading a team of approximately 12 clinical and non-clinical professionals across onshore and global locations (including the U.S., Manila, and Puerto Rico), you will be accountable for onboarding, ongoing education, quality assurance, content management, and process improvement supporting over 500 commercial and enterprise clients nationwide.

Leveraging platforms such as EQT and Thought Industries, you will serve as a strategic operational leader driving quality standards and clinical education across utilization management, physician advisor functions, peer-to-peer review support, and appeals operations.

You'll enjoy the flexibility to work remotely
* from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

Lead and develop a multidisciplinary team of approximately 12 clinical and non-clinical training and quality auditor professionals across onshore and global locations

Support ongoing education including cross training education efforts across the existing ~400 FTEs in the Optum Physician Advisor & Utilization management team Direct the end-to-end design, development, enhancement, and delivery of training programs for new hire onboarding and ongoing operational education

Establish and oversee quality assurance processes, performance metrics, and audit dashboards across clinical and non-clinical utilization management workflows

Align training and quality initiatives with medical necessity guidelines, denial management protocols, physician advisor activities, and peer-to-peer review processes

Partner with stakeholders across physician, nursing, and operational teams to drive continuous quality improvement and address clinical knowledge gaps Oversee learning platforms and dashboard technologies (e.g., EQT tool, Thought Industries platform) to maintain high-quality learning content and track performance indicators

Manage global, multi-site operational standards across distributed teams to ensure high quality and client satisfaction across 500+ commercial and enterprise clients

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:

5+ years of people leadership experience managing clinical and non-clinical teams within a healthcare environment3+ years of experience leading training program development, quality assurance operations, or organizational education3+ years of experience in utilization management operations or utilization review environments3+ years of working knowledge of medical necessity criteria such as Inter Qual and MCG, physician advisor workflows and both concurrent and retrospective denials management.
2+ years of experience leading or managing globally distributed or multi-site teams

Active M.D., D.O., RN clinical credential/licensure

Preferred Qualifications:

Training experience at a management level

Demonstrated experience serving as a clinical peer, mentor, or leader across multidisciplinary teams (physicians, nurses, and non-clinical staff)

Experience with in a healthcare payer organization or large, complex health system with comparable scale

Direct experience supporting physician advisor operations, utilization review and denials management workflows

Hands-on experience with EQT dashboards or the Thought Industries training platform
*…