Medical Director - Post-Acute Care Management - Care Transitions - Remote anywhere in US
Optum
ST Louis, MO
1 day ago
$238,000 - $357,500
Job Description
Join Optum as a Medical Director in Post-Acute Care Management, where you'll leverage your expertise to enhance health outcomes and transform healthcare delivery. Enjoy the flexibility of remote work while making a significant impact on patient care across the U.S.
Key Responsibilities
Provide daily utilization oversight and external communication with network physicians and hospitals
Daily UM reviews - authorizations and denial reviews
Conduct peer to peer conversations for the clinical case reviews, as needed
Conduct provider telephonic review and discussion and share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care
Communicate effectively with network and non-network providers to ensure the successful administering of Care Transitions’ services
Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers
Represent Care Transitions on appropriate external levels identifying, engaging and establishing/maintaining relationships with other thought leaders
Collaborate with Client Services Team to ensure a coordinated approach to delivery system providers
Contribute to the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals
Interact, communicate, and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees
Provide leadership and guidance to maximize cost management through close coordination with all network and provider contracting
Regularly meet with Care Transitions’ leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues
Provide input on local needs for Analytics Team and Client Services Team to better enhance Care Transitions’ products and services
Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME
Participate on the Medical Advisory Board
Providing intermittent, scheduled weekend and evening coverage
Perform other duties and responsibilities as required, assigned, or requested
Required Qualifications
Board certification as an MD, DO, MBBS with a current unrestricted license to practice
Current, unrestricted medical license and the ability to obtain licensure in multiple states
3+ years of post-residency patient care, preferably in inpatient or post-acute setting
Preferred Qualifications
Licensure in multiple states
Willing to obtain additional state licenses, with Optum’s support
Understanding of population-based medicine, preferably with knowledge of CMS criteria for post-acute care
Demonstrated ability to work within a team environment while completing multiple tasks simultaneously
Demonstrated ability to complete assignments with reasonable oversight, direction, and supervision
Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals
Demonstrated competence in use of electronic health records as well as associated technology and applications
Proven excellent organizational, analytical, verbal and written communication skills
Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues
Proven highest level of ethics and integrity
Proven highly motivated, flexible and adaptable to working in a fast-paced, dynamic environment
Benefits & Perks
Comprehensive benefits packageIncentive and recognition programsEquity stock purchase401k contribution