Medical Case Manager jobs at Genex Services - 22 jobs

The Telephonic Case Manager II coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient's medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source Provide assessment, planning, implementation, and evaluation of patient's progress Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness Utilize medical and nursing knowledge to discuss the current treatment plan/alternate treatment plans with the physician Make medical recommendations of available treatment plans to the payer Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services Devise cost-effective strategies for medical care Required to prepare organized reports within a specified timeframe Minimum Productivity Standard is 95% per month Additional duties as assigned KNOWLEDGE & SKILLS: Ability to make independent medical decisions and recommendations to all parties Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers Excellent written and verbal communication skills Ability to meet designated deadlines Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management, and organizational skills Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Bachelor's degree required, BSN preferred Graduate of accredited school of nursing Current RN Licensure in state of operation 3 or more years of recent clinical experience, preferably in rehabilitation URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire Strong clinical background in orthopedics, neurology, or rehabilitation preferred Strong cost containment background, such as utilization review or managed care helpful Certification as a CIRS or CCM preferred PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $65,346 - $98,982 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote

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 together.** The Behavioral Medical Director position is responsible for providing oversight to and direction of the Utilization Management Program and performing peer reviews as necessary. This individual will interact directly with and offer clinical, procedural, or administrative recommendations to psychiatrists and other behavioral health providers, medical physicians and nurses, clinical professionals, and/or state agencies who care for members, or consult on various processes and programs. The Medical Director is part of a leadership team that manages development and implementation of evidence-based treatments and medical expense initiatives and will also advise leadership on health care system improvement opportunities. They are responsible for maintaining the clinical integrity of the program, including timely peer reviews, appeals and consultations with providers and other community-based clinicians, including general practitioners, and will work collaboratively with the Health Plan Medical Director, Clinical, Network and Quality staff. At Optum, our clinical vision drives the team to improve the quality of care our consumers receive. If you are located in New Jersey, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Ensuring delivery of cost-effective quality care that incorporates recovery, resiliency and person-centered services + Level of Care guidelines and utilization management protocols + Oversight and management, along with the Clinical Director and Clinical Program Director, utilization review, management and care coordination activities + Provide clinical oversight to the clinical staff, oversee the management of services at all levels of care in the benefit plan + Keep current regarding Evidence Based Practices and treatment philosophies including those that address Recovery and Resilience 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:** + Doctor of Medicine or Osteopathy + Current license to practice as a physician without restrictions + Board certified in Psychiatry; and Child and Adolescent Psychiatry + Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recovery + Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management + Computer and typing proficiency, data analysis and strong organizational skills necessary **Preferred Qualifications:** + 3+ years of experience as a practicing psychiatrist post residency + Managed care experience + Experience in public sector delivery systems and experience in state specific public sector services + Experience working with community-based programs and resources designed to aid the State Medicaid population *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $258,000 to $423,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

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 together.** The Behavioral Medical Director is responsible for overseeing and guiding the Utilization Management team. This individual will interact directly with Psychiatrists, Behavioral Health Providers, and other clinical professionals, such as Psychiatric Nurses, who consult on various complex clinical scenarios, processes and programs. The Behavioral Medical Director is part of a team that manages development and implementation of evidence-based treatments and medical expense initiatives and will also advise leadership on system improvement opportunities. They are responsible for timely peer reviews, appeals and consultations with providers and other community-based clinicians, including general practitioners, and will work collaboratively with utilization management, care management, quality, account management, and operations teams. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Ensuring delivery of cost-effective quality care that incorporates recovery, resiliency, and person-centered services + Implementation of Level of Care guidelines and Utilization Management protocols + Provide clinical oversight and support to the clinical staff, oversee the management of services at all levels of care in the benefit plan + Keep current regarding Evidence Based Practices and treatment philosophies including those that address Recovery and Resilience **The Behavioral Medical Director will support:** + Clinical review and oversight of behavioral health cases in collaboration with multidisciplinary team members + Peer-to-peer consultations + Compliance with state regulations and licensure + Quality assurance and audit readiness for accreditation 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:** + Doctor of Medicine or Osteopathy + Current license to practice as a physician without restrictions and willing to maintain necessary credentials to retain the position + Board certified in Psychiatry + Board certified in Child and Adolescent Psychiatry + Experience working in a multidisciplinary clinical team + Knowledge of post-discharge care planning such as home care, discharge planning, care management, and disease management + Computer and typing proficiency, data analysis, and organizational skills + Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals + Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation, and recovery + Demonstrated competence in use of electronic health records as well as associated technology and applications + Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues + Participate in rotational holiday and call coverage **Preferred Qualifications:** + 3+ years of experience as a practicing psychiatrist post residency + Managed care experience to include familiarity with Utilization Management guidelines + Familiar with behavioral services within the NY, NJ, CT Tri-State area; to include active licensure + Understanding of Medical Behavioral Integration and Whole Person Care concepts and application + Based in Eastern time zone + Willing to obtain additional state licensure, with support *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $268,000 to $414,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: + Award-winning culture + Inclusion and diversity as a priority + Performance Based Incentive Plans + Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability + Generous PTO (including paid time to volunteer!) + Up to 9.5% 401(k) employer contribution + Mental health support + Career advancement opportunities + Student loan repayment options + Tuition reimbursement + Flexible work environments **_*All the benefits listed above are subject to the terms of their individual Plans_** **.** And that's just the beginning... With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! **General Summary:** Unum is expanding its team of skilled Physicians focusing on Internal Medicine, Family Practice, Occupational Medicine, and Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The incumbent provides high quality, timely, and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to accepted norms of medical practices and Code of Conduct guidelines. Physicians and psychologists conduct their reviews and analyses within appropriate ethical standards and maintain their professional licenses and Board certifications. This role is expected to provide excellent customer service and to interact on a regular basis with business partners, health care providers, and other specialized resources. **Principal Duties and Responsibilities** + Provide timely, clear medical direction and opinions to team partners, with reasoned forensic analysis to support the medical opinions + Partner/consult with fellow medical consultants when appropriate to ensure the completion of a whole person analysis + Apply medical knowledge to determine functional capacity through assessment of medical and other data related to impairment, regarding accuracy of diagnoses, treatment plans, duration guidelines, and prognosis + Provide relevant medical education and knowledge to others in terms appropriate and understandable to the intended audience + Perform telephone contacts with the insured's healthcare providers to gather medical information and to facilitate a better understanding of the claimant's functional abilities + Make timely and appropriate referrals for second opinion reviews when appropriate or required according to current guidelines and best practices + Demonstrate ability to manage and complete high volumes of assigned work, maintain consistently good turnaround times, and operate with a sense of urgency + Focus not only on individual workload, but on the team/group work volumes to ensure organizational success + Receive feedback and follow through with appropriate behaviors/actions + Perform other duties as assigned **Job Specifications** + Professional Degree (MD, DO, PhD, PsyD) + Active, unrestricted US medical license + Board certification required for physicians the preferred area of specialty: Internal Medicine, Family Medicine, Physical Medicine & Rehabilitation, Emergency Medicine, or Occupational Medicine + Minimum of five years of clinical experience in medical specialty + Strong team and collaborative skills. Ability to work in a fast paced, team based, corporate environment + Ability to mentor others and to give and receive constructive, behaviorally based feedback with peers and partners \#IN1 \#LI-RA1 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $133,500.00-$274,100.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

Our Case Managers play a vital role in the satisfaction of our clients, guiding them through the insurance process, listening to them, and addressing their needs. They demonstrate knowledge and compassion and thrive in a fast-paced environment, helping clients protect their families. Why Zander? Right now, most of us are looking for stability - and that's just what you get at Zander. We're a family-and-employee-owned agency that has been in business for nearly 100 years, hold the 20-year endorsement of Dave Ramsey, and are a debt-free company. What we have to offer: Health and dental insurance paid 100% by Zander Meaningful work protecting families Employee Stock Ownership Plan after one year Industry-leading compensation including base salary plus bonuses 5% dollar-for-dollar matching on your 401(k) Generous paid time off Growth and leadership opportunities - we promote from within And much more! Your role in protecting families will include: Answering incoming calls Making outbound follow-up calls Working as the guide through the insurance process Meeting weekly metrics Who you are: You have a great attitude and the heart of a teacher You thrive in a fast-paced environment You are reliable, adaptable, and compassionate You have basic knowledge of Microsoft Office programs You have a typing speed of at least 40wpm You have inbound and outbound call experience and can handle high call volume You have the ability to work from home ESSENTIAL FUNCTIONS: These essential functions are representative of those that must be met by an employee to successfully perform the physical aspects of the job. Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions. Use of office equipment including personal computer, multiple screens, printer, fax machine, scanner and telephone; The employee is occasionally required to use hands and fingers to operate, handle, and reach; Specific vision abilities required by this job include close vision and the ability to adjust focus; Communicate effectively in English, writing and verbally in person, via email and via telephone; Communicate effectively via telephone for extended periods of time, up to 7 hours per day; Ability to pay attention, listen actively, analyze problems and evaluate options, focused on task, multi-task, decision making, and engage appropriately; Ability to appropriately handle stress in a fast-paced environment and interact appropriately with others; Sit & stand for extended periods of time up to 7 hours per day; Must be able to walk up and down stairs (there are no elevators in the 2-story main office building); Physical, consistent attendance during normal working hours within a standard 40-hour workweek, as many of the job duties are time sensitive and most effectively and efficiently resolved only through required immediate communication; additional hours may be required; The noise level in the work environment is usually moderate to loud. WE ARE AN EQUAL OPPORTUNITY EMPLOYER Applicants are considered for position and are evaluated without regard to mental or physical disability, race, religion, sexual orientation, color, gender, national origin, age, marital status, military or veteran status or any other protected local, state or federal status unrelated to the performance of the work involved. COMMUNICATION NOTICE As part of our hiring process, we may contact candidates by text message for interview reminders or scheduling updates. By applying, you consent to receiving job related text messages from Zander Insurance. If you prefer not to receive texts, you can reply STOP at any time to opt out.

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: + Award-winning culture + Inclusion and diversity as a priority + Performance Based Incentive Plans + Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability + Generous PTO (including paid time to volunteer!) + Up to 9.5% 401(k) employer contribution + Mental health support + Career advancement opportunities + Student loan repayment options + Tuition reimbursement + Flexible work environments **_*All the benefits listed above are subject to the terms of their individual Plans_** **.** And that's just the beginning... With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! **General Summary:** Unum is expanding its team of skilled Physicians focusing on Internal Medicine, Family Practice, Occupational Medicine, and Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The incumbent provides high quality, timely, and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to accepted norms of medical practices and Code of Conduct guidelines. Physicians and psychologists conduct their reviews and analyses within appropriate ethical standards and maintain their professional licenses and Board certifications. This role is expected to provide excellent customer service and to interact on a regular basis with business partners, health care providers, and other specialized resources. **Principal Duties and Responsibilities** + Provide timely, clear medical direction and opinions to team partners, with reasoned forensic analysis to support the medical opinions + Partner/consult with fellow medical consultants when appropriate to ensure the completion of a whole person analysis + Apply medical knowledge to determine functional capacity through assessment of medical and other data related to impairment, regarding accuracy of diagnoses, treatment plans, duration guidelines, and prognosis + Provide relevant medical education and knowledge to others in terms appropriate and understandable to the intended audience + Perform telephone contacts with the insured's healthcare providers to gather medical information and to facilitate a better understanding of the claimant's functional abilities + Make timely and appropriate referrals for second opinion reviews when appropriate or required according to current guidelines and best practices + Demonstrate ability to manage and complete high volumes of assigned work, maintain consistently good turnaround times, and operate with a sense of urgency + Focus not only on individual workload, but on the team/group work volumes to ensure organizational success + Receive feedback and follow through with appropriate behaviors/actions + Perform other duties as assigned **Job Specifications** + Professional Degree (MD, DO, PhD, PsyD) + Active, unrestricted US medical license + Board certification required for physicians the preferred area of specialty: Internal Medicine, Family Medicine, Physical Medicine & Rehabilitation, Emergency Medicine, or Occupational Medicine + Minimum of five years of clinical experience in medical specialty + Strong team and collaborative skills. Ability to work in a fast paced, team based, corporate environment + Ability to mentor others and to give and receive constructive, behaviorally based feedback with peers and partners \#IN1 \#LI-RA1 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $133,500.00-$274,100.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

✨Join a group of passionate advocates on our mission to improve the lives of at-risk youth! Rite of Passage Team is hiring for a Medical Director - Child & Adolescent Psychiatry at Childhelp, Alice C. Tyler Village in Lignum, Virginia✨ Childhelp is a psychiatric residential treatment facility that specializes in the treatment of children aged 5-14 with mild to severe trauma or neglect, psychiatric disorders, and neurodevelopmental disorders. Our unique location on a 270-acre farm provides a nurturing treatment setting with a variety of therapy resources. We bring the light of love and healing into the lives of countless abused and neglected children, and those suffering from psychiatric and behavioral disorders. We take a holistic approach to serving our children along with meeting their physical, emotional and educational needs. Becoming a member of our Childhelp team is more than a job, it's an opportunity to create a meaningful career with a mission driven organization. Pay: To be determined based on Education and Experience. $200,000-$350,000 Perks & Benefits: Medical, Dental, Vision and company paid Life Insurance within 90 days, and 401k match of up to 6% after 1 year of employment, Paid Time Off that can be used as soon as it accrues and more! ROP-benefits-and-perks-2 What you will do: The Medical Director works as a member of the Student Services team. Primarily responsible to ensure that the health and welfare of the students is maintained. Provides mental health care including diagnosis, psychiatric evaluations and testing, and medication management to the children in residential placement. The Psychiatric Medical Authority reports to the Program Director and supervises work performed by contracted Psychiatic Mental Health Nurse Practitioners or other contracted Psychiatrists. To be considered you should: Medical Doctor/Physician License to practice in the state of Virginia ~ Possess a current and valid certification ~ Have related experience working with at-risk youth ages 5-14 ~ Prior expereince with child mental heatlh conditions and treatment ~ Be able to pass a criminal background check, drug screen, physical, and TB test. Schedule: Monday through Friday Apply today and Make a Difference in the Lives of Youth! After 40 years of improving the lives of youth, we are looking for passionate advocates to continue the legacy of helping young people become successful adults. As a Medical Director - Child & Adolescent Psychiatry , you will have the unique opportunity to create a positive, safe and supportive environment for the youth we serve while building a career rich in growth opportunities and self-fulfillment. Follow us on Social! Instagram / Facebook / Linkedin / Tik Tok / YouTube

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 together.** The Clinical Coverage Review **Medical Director** is a key member of the Optum Enterprise Clinical Services Team. On the Focused **Pharmacy Review** team, they are responsible for providing physician support to Optum Rx Pharmacy Team, and to Clinical Coverage Review (CCR) operations, the organization responsible for the initial clinical review of service requests for UnitedHealth Care (UHC). The Medical Director collaborates with Optum Rx and CCR leadership and staff to establish, implement, support, and maintain clinical and operational processes related to outpatient pharmacy and medical coverage determinations. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), with a focus on outpatient pharmacy reviews, and on communication regarding this process with both network and non-network physicians, as well as other UnitedHealth Group departments. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided + Conduct coverage review on some medical cases, based on individual member plan documents, and national and proprietary coverage review guidelines, render coverage determinations, and discuss with requesting providers as needed in peer-to-peer telephone calls + Use clinical knowledge in the application and interpretation of medical and pharmacy policy and benefit document language in the process of clinical coverage review's guidelines + Conduct daily clinical review and evaluation of all service requests collaboratively with Clinical Coverage Review staff + Provide support for CCR nurses, pharmacists, and non-clinical staff in multiple sites in a manner conducive to teamwork + Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants; educates providers on benefit plans and UHC medical policy + Communicate with and assist Medical Directors outside CCR regarding coverage and other pertinent issues + Communicate and collaborate with other departments such as the Inpatient Concurrent Review team regarding coverage and other issues + Is available and accessible to the CCR staff throughout the day to respond to inquiries. Serve as a clinical resource, coach, and leader within CCR + Access clinical specialty panel to assist or obtain assistance in complex or difficult cases + Document clinical review findings, actions, and outcomes in accordance with CCR policies, and regulatory and accreditation requirements + Actively participate as a key member of the CCR team in regular meetings and projects focused on communication, feedback, problem solving, process improvement, staff training and evaluation and sharing of program results + Actively participate in identifying and resolving problems and collaborates in process improvements that may be outside own team + Provide clinical and strategic leadership when participating on national committees and task forces focused on achieving Clinical Coverage Review goals + Ability to obtain additional state medical licenses as needed + Participate in rotational weekend and holiday call coverage + Other duties and goals assigned by the medical director's supervisor 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:** + Active, unrestricted physician license + Current board certification in Gastroenterology + 5+ years of clinical practice experience in Gastroenterology after completing residency training + Substantial experience in using electronic clinical systems + Ability to participate in rotational weekend and holiday call coverage + Solid belief in EBM (Evidence Based Medicine), and familiarity with current medical issues and practices + PC skills, specifically using MS Word, Outlook, and Excel **Preferred Qualifications:** + Hands-on experience in utilization review + Clinical practice experience in the last 2 years + Sound knowledge of the managed care industry + Data analysis and interpretation experience and skills + Excellent presentation skills for both clinical and non-clinical audiences *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

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 together. The Clinical Coverage Review Medical Director is a key member of the Optum Enterprise Clinical Services Team. On the Focused Pharmacy Review team, they are responsible for providing physician support to Optum Rx Pharmacy Team, and to Clinical Coverage Review (CCR) operations, the organization responsible for the initial clinical review of service requests for UnitedHealth Care (UHC). The Medical Director collaborates with Optum Rx and CCR leadership and staff to establish, implement, support, and maintain clinical and operational processes related to outpatient pharmacy and medical coverage determinations. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), with a focus on outpatient pharmacy reviews, and on communication regarding this process with both network and non-network physicians, as well as other UnitedHealth Group departments. 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: * Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided * Conduct coverage review on some medical cases, based on individual member plan documents, and national and proprietary coverage review guidelines, render coverage determinations, and discuss with requesting providers as needed in peer-to-peer telephone calls * Use clinical knowledge in the application and interpretation of medical and pharmacy policy and benefit document language in the process of clinical coverage review's guidelines * Conduct daily clinical review and evaluation of all service requests collaboratively with Clinical Coverage Review staff * Provide support for CCR nurses, pharmacists, and non-clinical staff in multiple sites in a manner conducive to teamwork * Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants; educates providers on benefit plans and UHC medical policy * Communicate with and assist Medical Directors outside CCR regarding coverage and other pertinent issues * Communicate and collaborate with other departments such as the Inpatient Concurrent Review team regarding coverage and other issues * Is available and accessible to the CCR staff throughout the day to respond to inquiries. Serve as a clinical resource, coach, and leader within CCR * Access clinical specialty panel to assist or obtain assistance in complex or difficult cases * Document clinical review findings, actions, and outcomes in accordance with CCR policies, and regulatory and accreditation requirements * Actively participate as a key member of the CCR team in regular meetings and projects focused on communication, feedback, problem solving, process improvement, staff training and evaluation and sharing of program results * Actively participate in identifying and resolving problems and collaborates in process improvements that may be outside own team * Provide clinical and strategic leadership when participating on national committees and task forces focused on achieving Clinical Coverage Review goals * Ability to obtain additional state medical licenses as needed * Participate in rotational weekend and holiday call coverage * Other duties and goals assigned by the medical director's supervisor 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: * Active, unrestricted physician license * Current board certification in Rheumatology, Hematology-Oncology, Internal Medicine, Family Practice or Emergency Medicine * 5+ years of clinical practice experience after completing residency training * Substantial experience in using electronic clinical systems * Proven to participate in rotational weekend and holiday call coverage * Proven solid belief in EBM (Evidence Based Medicine), and familiarity with current medical issues and practices * Proven PC skills, specifically using MS Word, Outlook, and Excel Preferred Qualifications: * Clinical practice experience in the last 2 years * Hands-on experience in utilization review * Data analysis experience * Sound knowledge of the managed care industry * Proven data analysis and interpretation experience and skills Proven excellent presentation skills for both clinical and non-clinical audiences * Reside in PST or MST * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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 together.** The Clinical Coverage Review Medical Director is a key member of the Optum Enterprise Clinical Services Team. On the Focused Pharmacy Review team, they are responsible for providing physician support to Optum Rx Pharmacy Team, and to Clinical Coverage Review (CCR) operations, the organization responsible for the initial clinical review of service requests for UnitedHealth Care (UHC). The Medical Director collaborates with Optum Rx and CCR leadership and staff to establish, implement, support, and maintain clinical and operational processes related to outpatient pharmacy and medical coverage determinations. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), with a focus on outpatient pharmacy reviews, and on communication regarding this process with both network and non-network physicians, as well as other UnitedHealth Group departments. 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:** + Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided + Conduct coverage review on some medical cases, based on individual member plan documents, and national and proprietary coverage review guidelines, render coverage determinations, and discuss with requesting providers as needed in peer-to-peer telephone calls + Use clinical knowledge in the application and interpretation of medical and pharmacy policy and benefit document language in the process of clinical coverage review's guidelines + Conduct daily clinical review and evaluation of all service requests collaboratively with Clinical Coverage Review staff + Provide support for CCR nurses, pharmacists, and non-clinical staff in multiple sites in a manner conducive to teamwork + Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants; educates providers on benefit plans and UHC medical policy + Communicate with and assist Medical Directors outside CCR regarding coverage and other pertinent issues + Communicate and collaborate with other departments such as the Inpatient Concurrent Review team regarding coverage and other issues + Is available and accessible to the CCR staff throughout the day to respond to inquiries. Serve as a clinical resource, coach, and leader within CCR + Access clinical specialty panel to assist or obtain assistance in complex or difficult cases + Document clinical review findings, actions, and outcomes in accordance with CCR policies, and regulatory and accreditation requirements + Actively participate as a key member of the CCR team in regular meetings and projects focused on communication, feedback, problem solving, process improvement, staff training and evaluation and sharing of program results + Actively participate in identifying and resolving problems and collaborates in process improvements that may be outside own team + Provide clinical and strategic leadership when participating on national committees and task forces focused on achieving Clinical Coverage Review goals + Ability to obtain additional state medical licenses as needed + Participate in rotational weekend and holiday call coverage + Other duties and goals assigned by the medical director's supervisor 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:** + Active, unrestricted physician license + Current board certification in Rheumatology, Hematology-Oncology, Internal Medicine, Family Practice or Emergency Medicine + 5+ years of clinical practice experience after completing residency training + Substantial experience in using electronic clinical systems + Proven to participate in rotational weekend and holiday call coverage + Proven solid belief in EBM (Evidence Based Medicine), and familiarity with current medical issues and practices + Proven PC skills, specifically using MS Word, Outlook, and Excel **Preferred Qualifications:** + Clinical practice experience in the last 2 years + Hands-on experience in utilization review + Data analysis experience + Sound knowledge of the managed care industry + Proven data analysis and interpretation experience and skills Proven excellent presentation skills for both clinical and non-clinical audiences + Reside in PST or MST *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

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 together. The Clinical Coverage Review Medical Director is a key member of the Optum Enterprise Clinical Services Team. On the Focused Pharmacy Review team, they are responsible for providing physician support to Optum Rx Pharmacy Team, and to Clinical Coverage Review (CCR) operations, the organization responsible for the initial clinical review of service requests for UnitedHealth Care (UHC). The Medical Director collaborates with Optum Rx and CCR leadership and staff to establish, implement, support, and maintain clinical and operational processes related to outpatient pharmacy and medical coverage determinations. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), with a focus on outpatient pharmacy reviews, and on communication regarding this process with both network and non-network physicians, as well as other UnitedHealth Group departments. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Review and sign off on proposed pharmacist denials for preservice outpatient medication requests, after review of medical records when provided * Conduct coverage review on some medical cases, based on individual member plan documents, and national and proprietary coverage review guidelines, render coverage determinations, and discuss with requesting providers as needed in peer-to-peer telephone calls * Use clinical knowledge in the application and interpretation of medical and pharmacy policy and benefit document language in the process of clinical coverage review's guidelines * Conduct daily clinical review and evaluation of all service requests collaboratively with Clinical Coverage Review staff * Provide support for CCR nurses, pharmacists, and non-clinical staff in multiple sites in a manner conducive to teamwork * Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants; educates providers on benefit plans and UHC medical policy * Communicate with and assist Medical Directors outside CCR regarding coverage and other pertinent issues * Communicate and collaborate with other departments such as the Inpatient Concurrent Review team regarding coverage and other issues * Is available and accessible to the CCR staff throughout the day to respond to inquiries. Serve as a clinical resource, coach, and leader within CCR * Access clinical specialty panel to assist or obtain assistance in complex or difficult cases * Document clinical review findings, actions, and outcomes in accordance with CCR policies, and regulatory and accreditation requirements * Actively participate as a key member of the CCR team in regular meetings and projects focused on communication, feedback, problem solving, process improvement, staff training and evaluation and sharing of program results * Actively participate in identifying and resolving problems and collaborates in process improvements that may be outside own team * Provide clinical and strategic leadership when participating on national committees and task forces focused on achieving Clinical Coverage Review goals * Ability to obtain additional state medical licenses as needed * Participate in rotational weekend and holiday call coverage * Other duties and goals assigned by the medical director's supervisor 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: * Active, unrestricted physician license * Current board certification in Gastroenterology * 5+ years of clinical practice experience in Gastroenterology after completing residency training * Substantial experience in using electronic clinical systems * Ability to participate in rotational weekend and holiday call coverage * Solid belief in EBM (Evidence Based Medicine), and familiarity with current medical issues and practices * PC skills, specifically using MS Word, Outlook, and Excel Preferred Qualifications: * Hands-on experience in utilization review * Clinical practice experience in the last 2 years * Sound knowledge of the managed care industry * Data analysis and interpretation experience and skills * Excellent presentation skills for both clinical and non-clinical audiences * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: + Award-winning culture + Inclusion and diversity as a priority + Performance Based Incentive Plans + Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability + Generous PTO (including paid time to volunteer!) + Up to 9.5% 401(k) employer contribution + Mental health support + Career advancement opportunities + Student loan repayment options + Tuition reimbursement + Flexible work environments **_*All the benefits listed above are subject to the terms of their individual Plans_** **.** And that's just the beginning... With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! **General Summary:** This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The incumbent provides high quality, timely, and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to accepted norms of medical practices and Code of Conduct guidelines. Physicians and psychologists conduct their reviews and analyses within appropriate ethical standards and maintain their professional licenses and Board certifications. This role is expected to provide excellent customer service and to interact on a regular basis with business partners, health care providers, and other specialized resources. **Principal Duties and Responsibilities** + Provide timely, clear medical direction and opinions to team partners, with reasoned forensic analysis to support the medical opinions + Partner/consult with fellow medical consultants when appropriate to ensure the completion of a whole person analysis + Apply medical knowledge to determine functional capacity through assessment of medical and other data related to impairment, regarding accuracy of diagnoses, treatment plans, duration guidelines, and prognosis + Provide relevant medical education and knowledge to others in terms appropriate and understandable to the intended audience + Perform telephone contacts with the insured's healthcare providers to gather medical information and to facilitate a better understanding of the claimant's functional abilities + Make timely and appropriate referrals for second opinion reviews when appropriate or required according to current guidelines and best practices + Demonstrate ability to manage and complete high volumes of assigned work, maintain consistently good turnaround times, and operate with a sense of urgency + Focus not only on individual workload, but on the team/group work volumes to ensure organizational success + Receive feedback and follow through with appropriate behaviors/actions + Perform other duties as assigned **Job Specifications** + Professional Degree (MD, DO, PhD, PsyD) + Active, unrestricted US medical license + Board certification required for physicians in their area of specialty + Minimum of five years of clinical experience in medical specialty + Strong team and collaborative skills. Ability to work in a fast paced, team based, corporate environment + Ability to mentor others and to give and receive constructive, behaviorally based feedback with peers and partners \#IN1 \#LI-RA1 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $133,500.00-$274,100.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

The Chief Medical Officer will be responsible for the following key areas of focus: **Implements Clinical Strategy, Solution and Program Design-** Implements and advances the overall clinical strategy in support of the transformation of the health plan offerings to deliver value through exceptional patient and provider experience, high quality outcomes, more affordable care, and with the use of modernized digital, technology, and data capabilities. **Oversees Medical Management** - Provides strategic leadership and oversight for all medical management functions, including case management (CM), utilization management (UM), and escalated case review. Ensures policies, procedures, and governance frameworks are in place to deliver a high-functioning, compliant health plan that meets regulatory requirements and internal standards. Drives excellence in clinical quality and consistency across programs while maintaining a seamless, positive experience for members and providers. Partners with internal teams to monitor performance, resolve complex cases, and continuously improve processes that safeguard patient outcomes and operational integrity. **Serves as the External Clinical Face of Health Plan to the Market** - Acts as the primary clinical ambassador for Cigna Healthcare, engaging with clients of all sizes across employer groups, as well as consultants and brokers. Plays a critical role in the sales process, account management, and ongoing performance oversight by providing clinical insight and executive sponsorship. Builds and nurtures strategic relationships with key stakeholders to strengthen trust and partnership. Represents Cigna in the provider community to foster collaboration, influence clinical policy, and advance value-based care initiatives. Ensures that every external interaction reflects Cigna's commitment to quality, affordability, and an exceptional member experience. **Drives Clinical Product Strategy and Design** - Leads the development and execution of Cigna Healthcare's clinical product strategy to ensure a market-leading clinical value proposition and compelling external narrative. Shapes and oversees the design of differentiated programs, including best-in-class case management and innovative solutions in high-impact areas such as GLP-1 therapies, gene therapy, women's health, and other core and emerging clinical domains. Partners with product, technology, operations, and business teams to create solutions that deliver measurable outcomes, supported by robust proof points and performance metrics. Ensures that Cigna's clinical programs stand out in the marketplace through demonstrated results, scalability, and alignment with client needs, while reinforcing our commitment to quality, affordability, and innovation. **Implements and Advances Value-Based Care Strategy** - Leads the next chapter of Cigna Healthcare's value-based care (VBC) journey, including oversight of our ACO model and development of innovative approaches to strengthen plan-provider alignment. Drives adoption of VBC enablers such as data integration, performance measurement, and incentive structures that improve quality and affordability. Pilots novel care models and partnerships to accelerate transformation while ensuring alignment with the broader enterprise network strategy. Positions Cigna as a market leader in value-based care through measurable outcomes, proof points, and a compelling external narrative. **Collaboration Across Clinical Leadership** - Ability to work seamlessly with other clinical leaders across the enterprise, serving as a key member of the clinical leadership bench. Thought partner to the enterprise CMO and peers to ensure integration of clinical strategy with each business's objectives, fostering alignment and shared accountability. **Advances Clinical Data and AI Strategy** - Champions a data-first mindset to transform CHC's clinical strategy through advanced analytics and AI. Leads efforts to harness data and AI for superior member experience, personalized care, improved outcomes, and operational efficiency. Partners closely with data, technology, and business teams to identify and execute clinical use cases that drive measurable impact. Ensures all AI applications adhere to rigorous clinical standards and governance guardrails to maintain trust and safety. Positions Cigna Healthcare at the forefront of digital innovation by embedding AI into clinical workflows while maintaining transparency, compliance, and a commitment to quality. **Drives Health Equity Strategy** - Leads the design and implementation of the next phase of Cigna Healthcare's health equity strategy, ensuring measurable business impact and alignment with our mission. Embeds a health equity lens across clinical programs to drive better outcomes for all patients, reduce disparities, and improve access to high-quality care. Establishes clear proof points and performance metrics to demonstrate progress and accountability, while partnering across the enterprise to integrate equity principles into product design, policy, and care delivery. **Builds and Inspires our New Age Clinical Workforce-** Sets the sourcing, recruitment, and onboarding strategy for building the team of clinicians who can support and drive the business strategy. Ensures our clinical teams are supported, engaged, and inspired to deliver exceptional outcomes. Leads and executes strategies to make Cigna an employer of choice for clinical talent through a differentiated employee value proposition that ensures the sustainability and well-being of our teams. The CMO will be the major clinical voice for Cigna Healthcare's US market president and senior leadership team. **Partners with Enterprise Clinical Leadership** - Collaborates and engages Clinical leaders/peers across the enterprise to support the enterprise clinical strategy and build out clinical community. The successful candidate will be a forward-thinking, flexible physician executive with a broad understanding of the healthcare industry, its challenges and opportunities, and deep experience within health plans. This leader will know how to navigate the complexities of a health plan environment to deliver results that align clinical priorities with business strategy. They will demonstrate genuine intellectual curiosity and a collaborative mindset, working effectively across a complex, matrixed organization with a servant leadership disposition. The individual will be an innovative thinker and problem-solver with a proven ability to lead transformative change while fostering trust, engagement, and retention of top clinical talent. The ideal candidate will combine clinical expertise, digital and technology depth, and strong business acumen with a results-oriented focus-driving measurable impact on both clinical outcomes and enterprise growth objectives. **Experience & Expertise:** + **Clinical Execution** : Ability to deliver a clinical vision for the business. The skills to shape and implement the development of forward-looking strategies that align with overarching enterprise objectives. Can identify opportunities for improvement that balance profitable business and clinical outcomes (e.g., patient outcomes, cost containment, and quality of healthcare services). + **Enterprise Value Creation and Scaling Commercial Solutions** : Ability to align clinical metrics/outcomes with a direct linkage to enterprise value creation and member health to create a clear mandate and accountability that prioritizes high-value areas. Experience overseeing the end-to-end development and scaling of healthcare solutions. Can drive innovation through the implementation of technologies and care models. Strong understanding of finance, technology, and the levers to pull in business development and sales. + **Thought Leadership and Clinical Face-To-Market** : Track record of engaging with diverse external stakeholders in the community to stay informed and shape the latest clinical and policy developments. Experience serving as the clinical face outside the organization to help inform and validate decision-making processes and provide insight supporting the business development lifecycle. Fosters collaborations to enhance care delivery and contribute to discussions in the public policy arena. Plays a crucial role in market-facing change and crisis management communications related to the Cigna health plan, ensuring effective and clear messaging to all stakeholders. + **Clinical Leadership** : Gravitas to serve as the highest point of clinical leadership in Cigna Healthcare. Skills and experience to effectively have end-to-end oversight of the clinical model (including P&L) for all programs and care delivery businesses while creating a high-quality patient care culture. Can balance clinical choices with business outcomes to gain market traction and deliver financial results. + **Health Plan and Medical Management Expertise** : Deep experience operating within health plan environments, including fluency in medical management functions such as utilization management (UM), case management (CM), policy development, and governance. Proven ability to navigate complex plan structures and deliver compliant, high-performing operations that enhance member experience and clinical quality. + **Transformation & Change** : Leads masterfully and empathetically through change in a complex matrixed environment (e.g., transformation of ways of working/processes, vision/priorities/culture and technology application). Manages transformation through practices such as creating a vision and purpose, frequent and timely communication, leadership alignment, stakeholder engagement, educating/training the organization, and overcoming resistance. Builds strong working relationships rooted in collaboration and trust. + **Value-Based Care** : Deep experience transitioning healthcare delivery models toward value-based care, emphasizing outcomes and cost-effectiveness. + **Building Next Generation Clinical Talent** : Has direct people management responsibility for a team through the full talent lifecycle: attracting, hiring, onboarding, developing, managing performance, and promoting talent, as well as existing team members when necessary. + **Compliance, Safety and Quality Care** : Cultivates a culture and fosters practice across the care delivery teams that prioritizes high quality, safe, and compliant operations within the Healthcare Sector. **REQUIRED SKILLS:** + MD/DO degree required; MBA and/or relevant business experience (10+ years) preferred. + 10+ years of experience in healthcare leadership. + Excellent leadership skills including the ability to think strategically, develop vision, and execute for results. + Proven thought leader of innovative, effective clinical solutions; must have end-to-end experience in deriving clinical and business value from clinical interventions, programs, and solutions. + Experience demonstrating iterative and synergistic solutions with near-term value delivery in service of longer-term pivots. + Experience with Commercial health plan product constructs, design, and innovative benefit structures. + Demonstrated ability to deliver creative solutions to complex challenges. + Experience working in a highly matrixed organization, with proven ability to develop internal enterprise relationships and influence partners. + Strong communication skills, particularly the ability to translate complex topics into consumable formats. + Willingness to travel as needed to support provider and regional team engagement. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. **About The Cigna Group** Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. _Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws._ _If you require reasonable accommodation in completing the online application process, please email:_ _*********************_ _for support. Do not email_ _*********************_ _for an update on your application or to provide your resume as you will not receive a response._ _The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._ _Qualified applicants with criminal histories will be considered for employment in a manner_ _consistent with all federal, state and local ordinances._

The Chief Medical Officer will be responsible for the following key areas of focus: Implements Clinical Strategy, Solution and Program Design- Implements and advances the overall clinical strategy in support of the transformation of the health plan offerings to deliver value through exceptional patient and provider experience, high quality outcomes, more affordable care, and with the use of modernized digital, technology, and data capabilities. Oversees Medical Management- Provides strategic leadership and oversight for all medical management functions, including case management (CM), utilization management (UM), and escalated case review. Ensures policies, procedures, and governance frameworks are in place to deliver a high-functioning, compliant health plan that meets regulatory requirements and internal standards. Drives excellence in clinical quality and consistency across programs while maintaining a seamless, positive experience for members and providers. Partners with internal teams to monitor performance, resolve complex cases, and continuously improve processes that safeguard patient outcomes and operational integrity. Serves as the External Clinical Face of Health Plan to the Market- Acts as the primary clinical ambassador for Cigna Healthcare, engaging with clients of all sizes across employer groups, as well as consultants and brokers. Plays a critical role in the sales process, account management, and ongoing performance oversight by providing clinical insight and executive sponsorship. Builds and nurtures strategic relationships with key stakeholders to strengthen trust and partnership. Represents Cigna in the provider community to foster collaboration, influence clinical policy, and advance value-based care initiatives. Ensures that every external interaction reflects Cigna's commitment to quality, affordability, and an exceptional member experience. Drives Clinical Product Strategy and Design- Leads the development and execution of Cigna Healthcare's clinical product strategy to ensure a market-leading clinical value proposition and compelling external narrative. Shapes and oversees the design of differentiated programs, including best-in-class case management and innovative solutions in high-impact areas such as GLP-1 therapies, gene therapy, women's health, and other core and emerging clinical domains. Partners with product, technology, operations, and business teams to create solutions that deliver measurable outcomes, supported by robust proof points and performance metrics. Ensures that Cigna's clinical programs stand out in the marketplace through demonstrated results, scalability, and alignment with client needs, while reinforcing our commitment to quality, affordability, and innovation. Implements and Advances Value-Based Care Strategy- Leads the next chapter of Cigna Healthcare's value-based care (VBC) journey, including oversight of our ACO model and development of innovative approaches to strengthen plan-provider alignment. Drives adoption of VBC enablers such as data integration, performance measurement, and incentive structures that improve quality and affordability. Pilots novel care models and partnerships to accelerate transformation while ensuring alignment with the broader enterprise network strategy. Positions Cigna as a market leader in value-based care through measurable outcomes, proof points, and a compelling external narrative. Collaboration Across Clinical Leadership- Ability to work seamlessly with other clinical leaders across the enterprise, serving as a key member of the clinical leadership bench. Thought partner to the enterprise CMO and peers to ensure integration of clinical strategy with each business's objectives, fostering alignment and shared accountability. Advances Clinical Data and AI Strategy- Champions a data-first mindset to transform CHC's clinical strategy through advanced analytics and AI. Leads efforts to harness data and AI for superior member experience, personalized care, improved outcomes, and operational efficiency. Partners closely with data, technology, and business teams to identify and execute clinical use cases that drive measurable impact. Ensures all AI applications adhere to rigorous clinical standards and governance guardrails to maintain trust and safety. Positions Cigna Healthcare at the forefront of digital innovation by embedding AI into clinical workflows while maintaining transparency, compliance, and a commitment to quality. Drives Health Equity Strategy- Leads the design and implementation of the next phase of Cigna Healthcare's health equity strategy, ensuring measurable business impact and alignment with our mission. Embeds a health equity lens across clinical programs to drive better outcomes for all patients, reduce disparities, and improve access to high-quality care. Establishes clear proof points and performance metrics to demonstrate progress and accountability, while partnering across the enterprise to integrate equity principles into product design, policy, and care delivery. Builds and Inspires our New Age Clinical Workforce- Sets the sourcing, recruitment, and onboarding strategy for building the team of clinicians who can support and drive the business strategy. Ensures our clinical teams are supported, engaged, and inspired to deliver exceptional outcomes. Leads and executes strategies to make Cigna an employer of choice for clinical talent through a differentiated employee value proposition that ensures the sustainability and well-being of our teams. The CMO will be the major clinical voice for Cigna Healthcare's US market president and senior leadership team. Partners with Enterprise Clinical Leadership - Collaborates and engages Clinical leaders/peers across the enterprise to support the enterprise clinical strategy and build out clinical community. The successful candidate will be a forward-thinking, flexible physician executive with a broad understanding of the healthcare industry, its challenges and opportunities, and deep experience within health plans. This leader will know how to navigate the complexities of a health plan environment to deliver results that align clinical priorities with business strategy. They will demonstrate genuine intellectual curiosity and a collaborative mindset, working effectively across a complex, matrixed organization with a servant leadership disposition. The individual will be an innovative thinker and problem-solver with a proven ability to lead transformative change while fostering trust, engagement, and retention of top clinical talent. The ideal candidate will combine clinical expertise, digital and technology depth, and strong business acumen with a results-oriented focus-driving measurable impact on both clinical outcomes and enterprise growth objectives. Experience & Expertise: * Clinical Execution: Ability to deliver a clinical vision for the business. The skills to shape and implement the development of forward-looking strategies that align with overarching enterprise objectives. Can identify opportunities for improvement that balance profitable business and clinical outcomes (e.g., patient outcomes, cost containment, and quality of healthcare services). * Enterprise Value Creation and Scaling Commercial Solutions: Ability to align clinical metrics/outcomes with a direct linkage to enterprise value creation and member health to create a clear mandate and accountability that prioritizes high-value areas. Experience overseeing the end-to-end development and scaling of healthcare solutions. Can drive innovation through the implementation of technologies and care models. Strong understanding of finance, technology, and the levers to pull in business development and sales. * Thought Leadership and Clinical Face-To-Market: Track record of engaging with diverse external stakeholders in the community to stay informed and shape the latest clinical and policy developments. Experience serving as the clinical face outside the organization to help inform and validate decision-making processes and provide insight supporting the business development lifecycle. Fosters collaborations to enhance care delivery and contribute to discussions in the public policy arena. Plays a crucial role in market-facing change and crisis management communications related to the Cigna health plan, ensuring effective and clear messaging to all stakeholders. * Clinical Leadership: Gravitas to serve as the highest point of clinical leadership in Cigna Healthcare. Skills and experience to effectively have end-to-end oversight of the clinical model (including P&L) for all programs and care delivery businesses while creating a high-quality patient care culture. Can balance clinical choices with business outcomes to gain market traction and deliver financial results. * Health Plan and Medical Management Expertise: Deep experience operating within health plan environments, including fluency in medical management functions such as utilization management (UM), case management (CM), policy development, and governance. Proven ability to navigate complex plan structures and deliver compliant, high-performing operations that enhance member experience and clinical quality. * Transformation & Change: Leads masterfully and empathetically through change in a complex matrixed environment (e.g., transformation of ways of working/processes, vision/priorities/culture and technology application). Manages transformation through practices such as creating a vision and purpose, frequent and timely communication, leadership alignment, stakeholder engagement, educating/training the organization, and overcoming resistance. Builds strong working relationships rooted in collaboration and trust. * Value-Based Care: Deep experience transitioning healthcare delivery models toward value-based care, emphasizing outcomes and cost-effectiveness. * Building Next Generation Clinical Talent: Has direct people management responsibility for a team through the full talent lifecycle: attracting, hiring, onboarding, developing, managing performance, and promoting talent, as well as existing team members when necessary. * Compliance, Safety and Quality Care: Cultivates a culture and fosters practice across the care delivery teams that prioritizes high quality, safe, and compliant operations within the Healthcare Sector. REQUIRED SKILLS: * MD/DO degree required; MBA and/or relevant business experience (10+ years) preferred. * 10+ years of experience in healthcare leadership. * Excellent leadership skills including the ability to think strategically, develop vision, and execute for results. * Proven thought leader of innovative, effective clinical solutions; must have end-to-end experience in deriving clinical and business value from clinical interventions, programs, and solutions. * Experience demonstrating iterative and synergistic solutions with near-term value delivery in service of longer-term pivots. * Experience with Commercial health plan product constructs, design, and innovative benefit structures. * Demonstrated ability to deliver creative solutions to complex challenges. * Experience working in a highly matrixed organization, with proven ability to develop internal enterprise relationships and influence partners. * Strong communication skills, particularly the ability to translate complex topics into consumable formats. * Willingness to travel as needed to support provider and regional team engagement. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide: + Award-winning culture + Inclusion and diversity as a priority + Performance Based Incentive Plans + Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability + Generous PTO (including paid time to volunteer!) + Up to 9.5% 401(k) employer contribution + Mental health support + Career advancement opportunities + Student loan repayment options + Tuition reimbursement + Flexible work environments **_*All the benefits listed above are subject to the terms of their individual Plans_** **.** And that's just the beginning... With 10,000 employees helping more than 39 million people worldwide, every role at Unum is meaningful and impacts the lives of our customers. Whether you're directly supporting a growing family, or developing online tools to help navigate a difficult loss, customers are counting on the combined talents of our entire team. Help us help others, and join Team Unum today! **General Summary:** This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across Unum US product lines. The incumbent provides high quality, timely, and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal workflow standards as set forth in the Benefits Center Claims Manual, underwriting manual, and associated documentation. The incumbent adheres to accepted norms of medical practices and Code of Conduct guidelines. Physicians and psychologists conduct their reviews and analyses within appropriate ethical standards and maintain their professional licenses and Board certifications. This role is expected to provide excellent customer service and to interact on a regular basis with business partners, health care providers, and other specialized resources. **Principal Duties and Responsibilities** + Provide timely, clear medical direction and opinions to team partners, with reasoned forensic analysis to support the medical opinions + Partner/consult with fellow medical consultants when appropriate to ensure the completion of a whole person analysis + Apply medical knowledge to determine functional capacity through assessment of medical and other data related to impairment, regarding accuracy of diagnoses, treatment plans, duration guidelines, and prognosis + Provide relevant medical education and knowledge to others in terms appropriate and understandable to the intended audience + Perform telephone contacts with the insured's healthcare providers to gather medical information and to facilitate a better understanding of the claimant's functional abilities + Make timely and appropriate referrals for second opinion reviews when appropriate or required according to current guidelines and best practices + Demonstrate ability to manage and complete high volumes of assigned work, maintain consistently good turnaround times, and operate with a sense of urgency + Focus not only on individual workload, but on the team/group work volumes to ensure organizational success + Receive feedback and follow through with appropriate behaviors/actions + Perform other duties as assigned **Job Specifications** + Professional Degree (MD, DO, PhD, PsyD) + Active, unrestricted US medical license + Board certification required for physicians in their area of specialty + Minimum of five years of clinical experience in medical specialty + Strong team and collaborative skills. Ability to work in a fast paced, team based, corporate environment + Ability to mentor others and to give and receive constructive, behaviorally based feedback with peers and partners \#IN1 \#LI-RA1 Unum and Colonial Life are part of Unum Group, a Fortune 500 company and leading provider of employee benefits to companies worldwide. Headquartered in Chattanooga, TN, with international offices in Ireland, Poland and the UK, Unum also has significant operations in Portland, ME, and Baton Rouge, LA - plus over 35 US field offices. Colonial Life is headquartered in Columbia, SC, with over 40 field offices nationwide. Unum is an equal opportunity employer, considering all qualified applicants and employees for hiring, placement, and advancement, without regard to a person's race, color, religion, national origin, age, genetic information, military status, gender, sexual orientation, gender identity or expression, disability, or protected veteran status. The base salary range for applicants for this position is listed below. Unless actual salary is indicated above in the job description, actual pay will be based on skill, geographical location and experience. $133,500.00-$274,100.00 Additionally, Unum offers a portfolio of benefits and rewards that are competitive and comprehensive including healthcare benefits (health, vision, dental), insurance benefits (short & long-term disability), performance-based incentive plans, paid time off, and a 401(k) retirement plan with an employer match up to 5% and an additional 4.5% contribution whether you contribute to the plan or not. All benefits are subject to the terms and conditions of individual Plans. Company: Unum

Explore opportunities with Suncrest Home Health, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Home Health Patient Care Manager, you are responsible for the overall supervision and coordination of clinical services. Coordinates and supervises an interdisciplinary team of staff to assure the continuity of high-quality care to home health patients assigned to the team's area in accordance with physician prescribed plan of care, and all applicable state and federal laws and regulations. Primary Responsibilities: * Provides clinical services within the scope of practice, as defined by the state laws governing the practice of nursing, in accordance with the plan of care, and in coordination with other members of the health care team * Receives referrals, ensures appropriate clinician assignments, evaluate patient orders, and plot start of care visits * Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals * Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance with physician orders * Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate 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: * Current unrestricted RN licensure in state of practice * Current CPR certification requirements * Current driver's license, vehicle insurance, and access to a dependable vehicle or public transportation * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client Preferred Qualifications: * Home care experience * Able to work independently * Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Explore opportunities with Baptist Reynolds Hospice House, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Patient Care Manager -Hospice assists Executive Administrator/Executive Director/Director of Clinical Operations with all patient care activities to ensure the delivery of safe and efficient patient care which adheres to relevant standards of accepted nursing, regulatory, medical practice, and payer source criteria. Primary Responsibilities: * Responsible for compliance with hospice policies and procedures and with local, state, and federal regulatory requirements governing the practice of the assigned team * Actively promotes and directs assigned team regarding quality of care and safety of patients and staff * Engages in thorough problem resolution and complaint investigation * Provides in-services to staff to promote the health and safety of the patient, to familiarize staff with regulatory issues and agency policy and procedures, and to address any identified educational needs 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: * Current unrestricted RN licensure in state of practice * 1+ years of clinical experience * Current CPR certification requirements * Current driver's license, vehicle insurance, and access to a dependable vehicle or public transportation * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client Preferred Qualifications: * 4+ years full-time experience as an RN or equivalent * Able to work independently * Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. #LHCJobs At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Explore opportunities with HighPoint Homecare, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Home Health Patient Care Manager, you are responsible for the overall supervision and coordination of clinical services. Coordinates and supervises an interdisciplinary team of staff to assure the continuity of high-quality care to home health patients assigned to the team's area in accordance with physician prescribed plan of care, and all applicable state and federal laws and regulations. Primary Responsibilities: * Provides clinical services within the scope of practice, as defined by the state laws governing the practice of nursing, in accordance with the plan of care, and in coordination with other members of the health care team * Receives referrals, ensures appropriate clinician assignments, evaluate patient orders, and plot start of care visits * Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals * Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance with physician orders * Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate 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: * Current unrestricted RN licensure in state of practice * Current CPR certification requirements * Current driver's license, vehicle insurance, and access to a dependable vehicle or public transportation * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client Preferred Qualifications: * Home care experience * Able to work independently * Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. #LHCJobs At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Explore opportunities with HighPoint Homecare, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As the Home Health Patient Care Manager, you are responsible for the overall supervision and coordination of clinical services. Coordinates and supervises an interdisciplinary team of staff to assure the continuity of high-quality care to home health patients assigned to the team's area in accordance with physician prescribed plan of care, and all applicable state and federal laws and regulations. **Primary Responsibilities:** + Provides clinical services within the scope of practice, as defined by the state laws governing the practice of nursing, in accordance with the plan of care, and in coordination with other members of the health care team + Receives referrals, ensures appropriate clinician assignments, evaluate patient orders, and plot start of care visits + Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals + Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance with physician orders + Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate 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:** + Current unrestricted RN licensure in state of practice + Current CPR certification requirements + Current driver's license, vehicle insurance, and access to a dependable vehicle or public transportation + Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client **Preferred Qualifications:** + Home care experience + Able to work independently + Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. **\#LHCJobs** _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._