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National Medical Director, Kidney Resource Solutions (Nephrologist) - Telecommute

UnitedHealth Group

Minneapolis, MN
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Job Details

760441 National Medical Director Kidney Resource Solutions Nephrologist Telecommute

National Medical Director, Kidney Resource Solutions (Nephrologist) - Telecommute (760441)

Position Description

Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 6 industry leader. Transforming health care and millions of lives starts with the values you embrace and the passion you bring. Find out more and join us. It's an opportunity to do your life's best work.(sm)



Optum is offering a unique opportunity for the qualified National Medical Director (Nephrologist) to change the way ESRD patients are managed, and truly effect a change in healthcare that will help healthcare work better for this patient population every day.  The Nephrologist will provide clinical leadership and expertise for the development of a new End Stage Renal Disease product, including new solutions already under way. They will be involved in utilization management, quality of care, Centers of Excellence (COE) qualification and appeals, product development, operations improvement, provider and customer management, the development of clinical programs and evidence-based medical benchmarks.


Primary Responsibilities:

  • Collaboratively works with the clinical leadership including individual product medical directors, product directors, managers, and clinical and operational staff to optimize product value and delivery, operational efficiencies, and meet or exceed clinical and business goals
  • Stays up-to-date and well-informed on each product, including the application of product-specific clinical guidelines and use of clinical documentation systems
  • Works with clinical, analytic and product development staff to develop strategies improve the care of members with kidney disease, including initiative project planning and performance measurement.
  • Provides utilization and case management support including day-to-day clinical case reviews with clinical staff, peer to peer interactions with care providers, and regular rounds with both clinical staff and major clients as appropriate.  Clinical benefit determinations and medical necessity review of cases as required.
  • Participates in team and committee quality and policy meetings, quality improvement projects, quality of care reviews, and process improvement activities.
  • Participates as a clinical leader in internal and external customer meetings and communicates with key stakeholders on a regular basis to establish strong relationships
  • Creates clinical strategies that will enable the team to meet or exceed performance guarantees, including capitation commitments, value based contract goals, and fees at risk guarantees.
  • Supports activities related to nurse clinical competencies, including identification of deficiencies and providing training
  • Serves as a resource and a frequently requested clinical expert for outside prospects and customers by assisting the sales and account management teams with RFP development and client meetings, including clinical sales presentations and creating new clinical presentations as requested
  • Attends national conferences as requested to meet with potential and existing customers
  • Participates in periodic reviews with operational leadership; including business metrics, trend reports, utilization metrics, customer reports, site/product and clinical performance metrics
  • Meets with internal and external customers and providers as a clinical leader representing the Complex Medical Conditions business
  • In partnership with operational and business leaders, identifies specialty network strategic and operational opportunities, assuring best practice is incorporated
  • Provides clinical leadership for newly deployed initiatives.  Assures effectiveness of products and programs through an established audit process and accurate reporting.
  • Assures that all accreditation, and performance standards are met and that all quality or potential liability issues are addressed

Required Qualifications:

  • Current and unrestricted MD or DO license
  • Board certified in an ABIM or AMBS; Nephrology  
  • 5+ years clinical practice experience
  • Strong background in the application of evidence - based medicine

Preferred Qualiications:

  • 2 years health plan experience as a Medical Director
  • Program and product development experience
  • Knowledge of managed care industry
  • Ability to travel  25%


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


Diversity creates a healthier atmosphere: 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: Nephrologist, Managed Care, Kidney, National, Physician, Medical Director

Job Details

  • Contest Number760441
  • Job TitleNational Medical Director, Kidney Resource Solutions (Nephrologist) - Telecommute
  • Job FamilyMedical and Clinical Operations
  • Business SegmentOptum Operations

Job Location Information

  • Minneapolis, MN
    United States
    North America
  • Other LocationsEden Prairie, MN
    Indianapolis, IN
    Boston, MA
    Austin, TX
    San Diego, CA

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job Level
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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