You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Provide consistent high-quality DRG-based clinical reviews within the Optum Enterprise Innovative DRG Clinical Review program and be an excellent written and spoken communicator (e.g., communication letters, engagement in peer-to-peer conversations) • Close collaboration with a team of medical directors, nurse coders, and operations team to deliver DRG Clinical Review performance • Identifying opportunities expand and optimize program success in collaboration with other programs, such as hospital utilization management and claims adjudication teams • Collaborate with IT partners to implement AI enhancements within programs • Participate in other Value Innovation programs, as assigned • Change Management • Participate in the cross collaboration with regional care delivery organizations through OH and Payment Integrity • Closely partner with IT on development and implementation of program delivery • Emotional Maturity and EQ • Establishing strong and lasting, trust-based relationships within team and external partners • Foster exemplary teamwork and strengthen a culture of continuous improvement and accountability • Take initiative and self-start attitude to approach problems with energy and passion • Demonstrate preference for working in a tight-knit team environment with diverse professional groups

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:

• M.D. or D.O. with an active, unrestricted medical license • Board certified in adult primary care fields (e.g. Internal Medicine, Family Medicine, Hospitalist) or related subspecialties • 3+ years of clinical experience post residency

Preferred Qualification:

• Experience with DRG clinical documentation and/or coding team collaboration within a hospital system or payor • Experience in chart review (DRG, UM, PA) or prior role as hospital physician advisor