Medical Director – Florida Licensed Physician | Remote (Florida, USA)
Requisition Number: 2317652
Category: Medical and Clinical Operations
Location: Orlando, Florida, United States
Work Model: Remote (Florida residents only)
Role Summary
Optum, a global healthcare organization committed to advancing clinical excellence and technology-enabled care, is seeking a Medical Director – Utilization Management licensed and residing in Florida. This role provides expert clinical oversight for benefit determinations, utilization management, and quality improvement within Enterprise Clinical Services.
The position focuses on ensuring that members receive appropriate, evidence-based, and cost-effective medical care. Physicians with strong clinical decision-making skills and experience in managed care, utilization review, or clinical quality programs are encouraged to apply.
Key Responsibilities
Perform medical coverage reviews based on member benefit plans, national guidelines, and proprietary policies.
Render accurate and timely benefit determinations.
Maintain detailed documentation of clinical review outcomes in compliance with regulatory standards.
Conduct peer-to-peer discussions with requesting providers, ensuring clarity of medical necessity and policy alignment.
Interpret benefit language and apply clinical guidelines during coverage decisions.
Participate in daily clinical rounds as requested by leadership.
Collaborate with network and non-network providers to improve care quality and efficiency.
Educate providers on medical policies, coverage criteria, and benefit structures.
Partner with internal operational teams to support effective clinical review workflows.
Required Qualifications
Candidates must meet all of the following criteria:
Doctor of Medicine (MD) or Doctor of Osteopathy (DO).
Active, unrestricted Florida medical license with no disciplinary actions.
Current board certification in Internal Medicine or Family Practice.
Minimum 5 years of clinical practice experience post-residency.
Proficiency in electronic clinical systems and digital medical records.
Strong knowledge of Evidence-Based Medicine (EBM) and current clinical practices.
Proficiency in Microsoft Word, Outlook, and Excel.
Ability to participate in rotational weekend and holiday call coverage.
Must currently reside in Florida.
Preferred Qualifications
Direct experience in utilization review or clinical coverage review.
Active clinical practice experience within the last two years.
Strong data analysis and interpretation skills.
Knowledge of managed care processes and regulatory frameworks.
Excellent presentation and communication skills for both clinical and non-clinical audiences.
Compensation and Benefits
Annual compensation range: USD 238,000 – 357,500, including base salary and performance-based bonus.
Salary influenced by experience, market conditions, and productivity.
Comprehensive benefits package, including:
Health and wellness coverage
Incentive and recognition programs
Employee stock purchase opportunities
401(k) contributions
Additional benefits based on eligibility
Work Environment
This role is remote for Florida residents and requires compliance with UnitedHealth Group’s Telecommuter Policy.
The job posting remains open for a minimum of two business days or until sufficient candidate applications are received.
About UnitedHealth Group
UnitedHealth Group aims to improve health outcomes and make the healthcare system work better for all. The organization promotes equity in care delivery, environmental responsibility, and access to high-quality healthcare for every individual.
UnitedHealth Group is an Equal Employment Opportunity employer and complies with all federal, state, and local employment regulations. All qualified candidates will be considered without regard to protected characteristics.
This is a drug-free workplace. Candidates must pass a drug test before beginning employment.
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