Chief Medical Officer – UCS Clinical Assessment Review Expert
Location: Minnetonka, Minnesota, USA (Remote considered within the U.S.)
Category: Medical and Clinical Operations
Requisition Number: 2319561
Position Overview
UnitedHealthcare is seeking a Chief Medical Officer – UCS Clinical Assessment Review Expert (CAREs) to lead national clinical programs across clinical quality, utilization management, financial performance, and operational excellence. This executive-level role requires a highly experienced physician leader with deep expertise in Utilization Management (UM), clinical operations, strategic planning, and healthcare management.
Reporting directly to the National Chief Medical Officer of Medical Management, the CMO will serve as a strategic partner, guiding clinical program value, compliance, affordability, and stakeholder satisfaction across clients, members, and provider networks.
This role offers the flexibility to work remotely from anywhere within the United States, subject to UnitedHealth Group’s telecommuter policies.
Key Responsibilities
Executive Leadership and Strategy
Provide executive leadership within the Office of Medical Management and oversight of the CAREs team.
Lead strategic planning, operational direction, and long-term vision for national clinical programs.
Partner with healthcare economics, operations, finance, network, and Line of Business (LOB) leaders to drive performance across utilization management programs.
Clinical and Operational Management
Oversee teams that monitor clinical quality, operational metrics, and affordability outcomes.
Evaluate clinical and financial data to identify process improvements and enhance program performance.
Guide clinical programs such as Inpatient Concurrent Review, Prior Authorization, and Medical Claims Review.
Cross-functional Collaboration
Partner with enterprise leaders to address program gaps, inform future clinical initiatives, and support growth opportunities.
Lead key executive meetings including LOB affordability sessions, joint operating committees, and Value Creation initiatives.
Build and maintain strong relationships with internal teams, Optum, UHG leadership, external delegates, and provider organizations.
Communication and Stakeholder Engagement
Present clinical findings, remediation strategies, and program outcomes to executive and non-clinical audiences.
Develop high-impact clinical communications and strategic content for internal and external stakeholders.
Navigate complex discussions using emotional intelligence and strong decision-making skills.
Governance and Compliance
Ensure compliance with all utilization management regulations (URAC, NCQA).
Support national clinical strategy as a delegate to the National Chief Medical Officer.
Provide oversight, coaching, and guidance to medical directors, reviewers, and clinical teams.
Required Qualifications
Education and Licensing
Doctor of Medicine (MD or DO) with an unrestricted medical license.
Experience Requirements
10+ years of clinical practice experience.
5+ years of national-level leadership experience managing teams, particularly Utilization Management teams.
5+ years of managed care experience across acute care, chronic condition management, and utilization management processes.
3+ years of direct collaboration with market presidents, national business unit leaders, COOs, and provider networks.
3+ years of presenting clinical and operational insights to executive-level audiences.
Technical and Functional Skills
Strong understanding of UM principles across pre-service, concurrent review, post-acute, and post-service functions.
Proficiency with evidence-based clinical decision-making tools such as InterQual.
Knowledge of URAC and NCQA standards.
Strong data analysis, interpretation, project management, and change leadership skills.
Experience managing high-impact provider and client-facing relationships.
Exceptional communication and presentation capabilities.
Preferred Attributes
Strategic thinker with strong business acumen.
Ability to collaborate effectively in matrixed organizations.
Skilled in influencing high-level decision-making.
Commitment to evidence-based medicine and quality improvement.
Compensation and Benefits
Salary range: USD 196,600 – USD 337,100 annually, depending on experience and market factors.
Benefits may include:
Comprehensive health coverage
Incentive and recognition programs
Equity stock purchase plan
401(k) contribution (subject to eligibility)
Additional Information
Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.
This role will remain posted for a minimum of two business days or until a qualified candidate pool is identified.
UnitedHealth Group is committed to equitable care, health system improvement, and reducing disparities across communities.
Equal Opportunity Statement
UnitedHealth Group is an Equal Employment Opportunity employer. All qualified applicants will receive consideration without regard to race, religion, national origin, age, sex, sexual orientation, gender identity, disability, veteran status, or any other protected characteristic.
UnitedHealth Group maintains a drug-free workplace; candidates must pass a drug screening prior to employment.
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Siliguri |Illinois :
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