Medical Director – Post-Acute Care Management – Care Transitions – Remote anywhere in US Position Available In Davidson, Tennessee

Job Description:

Optum Home & Community Care, part of the UnitedHealth Groupfamily of businesses, is creating something new in health care. Weare uniting industry-leading solutions to build an integrated caremodel that holistically addresses an individual’s physical, mentaland social needs

• helping patients access and navigate careanytime and anywhere.
• As a team member of our Care Transitions (naviHealth) product, wehelp change the way health care is delivered from hospital to homesupporting patients transitioning across care settings. Thislife-changing work helps give older adults more days at home.
• We’re connecting care to create a seamless health journey forpatients across care settings.

Join us to start Caring. Connecting.

Growing together.

• Why Care Transitions?

At Care Transitions, our mission is to work with extraordinarilytalented people who are committed to making a positive and powerfulimpact on society by transforming health care. Care Transitions isthe result of almost two decades of dedicated visionary leaders andinnovative organizations challenging the status quo for caretransition solutions. We do health care differently and we arechanging health care one patient at a time. Moreover, have agenuine passion and energy to grow within an aggressive and funenvironment, using the latest technologies in alignment with thecompany’s technical vision and strategy.

• You’ll enjoy the flexibility to work remotely
• from anywherewithin the U.S. as you take on some tough challenges. We arecurrently looking for Medical Directors that can work daytime inany of the continental time zones in the US.

• Primary Responsibilities:

  Provide daily utilization oversight and external communicationwith network physicians and hospitals Daily UM reviews

• authorizations and denial reviews Conduct peer to peer conversations for the clinical casereviews, as needed Conduct provider telephonic review and discussion and sharetools, information, and guidelines as they relate to cost-effectivehealthcare delivery and quality of care Communicate effectively with network and non-network providersto ensure the successful administering of Care Transitions’services Respond to clinical inquiries and serve as a non-promotionalmedical contact point for various healthcare providers Represent Care Transitions on appropriate external levelsidentifying, engaging and establishing/maintaining relationshipswith other thought leaders Collaborate with Client Services Team to ensure a coordinatedapproach to delivery system providers Contribute to the development of action plans and programs toimplement strategic initiatives and tactics to address areas ofconcern and monitor progress toward goals Interact, communicate, and collaborate with network andcommunity physicians, hospital leaders and other vendors regardingcare and services for enrollees Provide leadership and guidance to maximize cost managementthrough close coordination with all network and providercontracting Regularly meet with Care Transitions’ leadership to review carecoordination issues, develop collaborative intervention plans, andshare ideas about network management issues Provide input on local needs for Analytics Team and ClientServices Team to better enhance Care Transitions’ products andservices Ensure appropriate management/resolution of local queriesregarding patient case management either by responding directly orrouting these inquiries to the appropriate SME Participate on the Medical Advisory Board Providing intermittent, scheduled weekend and eveningcoverage Perform other duties and responsibilities as required,assigned, or requested•You’ll be rewarded and recognized for your performance in anenvironment that will challenge you and give you clear direction onwhat it takes to succeed in your role as well as providedevelopment for other roles you may be interested in.

RequiredQualifications:

Board certification as an

MD, DO, MBBS

with a currentunrestricted license to practice and willing to maintain necessarycredentials to retain the position Current, unrestricted medical license and the ability to obtainlicensure in multiple states 3+ years of post-residency patient care, preferably ininpatient or post-acute setting

• Preferred Qualifications:

• Licensure in multiple states Willing to obtain additional state licenses, with Optum’ssupport Understanding of population-based medicine, preferably withknowledge of CMS criteria for post-acute care Demonstrated ability to work within a team environment whilecompleting multiple tasks simultaneously Demonstrated ability to complete assignments with reasonableoversight, direction, and supervision Demonstrated ability to positively interact with otherclinicians, management, and all levels of medical and non-medicalprofessionals Demonstrated competence in use of electronic health records aswell as associated technology and applications Proven excellent organizational, analytical, verbal and writtencommunication skills Proven solid interpersonal skills with ability to communicateand build positive relationships with colleagues Proven highest level of ethics and integrity Proven highly motivated, flexible and adaptable to working in afast-paced, dynamic environment•All employees working remotely will be required to adhere toUnitedHealth Group’s Telecommuter Policy•The salary range for this role is $238,000 to $357,500 annuallybased on full-time employment.

Pay is based on several factorsincluding but not limited to local labor markets, education, workexperience, certifications, etc. UnitedHealth Group complies withall minimum wage laws as applicable. In addition to your salary,UnitedHealth Group offers benefits such as, a comprehensivebenefits package, incentive and recognition programs, equity stockpurchase and 401k contribution (all benefits are subject toeligibility requirements). No matter where or when you begin acareer with UnitedHealth Group, you’ll find a far-reaching choiceof benefits and incentives.

• Application Deadline:

  This will be posted for a minimum of 2business days or until a sufficient candidate pool has beencollected. Job posting may come down early due to volume ofapplicants.

• At UnitedHealth Group, our mission is to help people live healthierlives and make the health system work better for everyone.

Webelieve everyone-of every race, gender, sexuality, age, locationand income-deserves the opportunity to live their healthiest life.

Today, however, there are still far too many barriers to goodhealth which are disproportionately experienced by people of color,historically marginalized groups and those with lower incomes. Weare committed to mitigating our impact on the environment andenabling and delivering equitable care that addresses healthdisparities and improves health outcomes

• an enterprise priorityreflected in our mission.
• UnitedHealth Group is an Equal Employment Opportunity employerunder applicable law and qualified applicants will receiveconsideration for employment without regard to race, nationalorigin, religion, age, color, sex, sexual orientation, genderidentity, disability, or protected veteran status, or any othercharacteristic protected by local, state, or federal laws, rules,or regulations.
• UnitedHealth Group is a drug
• free workplace.

Candidates arerequired to pass a drug test before beginning employment.