Inpatient Care Management Medical Director - Remote

Lensa; Kahului (HI); Remote; USD 286,000 - 398,000; Full time

Job summary

Join a forward-thinking organization as an Inpatient Care Management Medical Director, where you can work remotely and make a significant impact on healthcare delivery. This role involves overseeing inpatient care utilization, collaborating with healthcare providers, and applying evidence-based guidelines to enhance patient outcomes. You will be part of a national team dedicated to advancing health equity and improving care quality. With a focus on professional growth and a supportive environment, this position offers a unique opportunity to leverage your medical expertise in a dynamic setting.

Benefits

Comprehensive Healthcare

Incentive Programs

Stock Options

401k Contributions

Qualifications

• Active medical license required, with 3+ years clinical practice experience.
• Proficiency in relevant software and systems is essential.

Responsibilities

• Conduct acute level of care and length of stay reviews for members.
• Collaborate with providers on clinical quality and care plan adjustments.

Skills

Clinical Practice

Evidence-Based Medicine

Utilization Management

Telecommuting

Education

MD or DO

Board Certification

Tools

Telehealth Software

Clinical Quality Management Systems

Job description

Inpatient Care Management Medical Director - Remote

1 day ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, UnitedHealth Group, is seeking professionals. Apply via Lensa today!

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. We foster a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Join us to make an impact on the communities we serve as we advance health equity globally. Caring. Connecting. Growing together.

We are currently seeking an Inpatient Care Management Medical Director to join our Optum team. This role involves conducting acute level of care and length of stay reviews for medical necessity for our members within the continuum of care. Our clients include local and national commercial employers, Medicare, and state Medicaid plans. Medical Directors collaborate with nurses and support staff to manage inpatient care utilization at various levels—hospital, market, regional, or national.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on meaningful challenges.

Primary Responsibilities

1. Participate in telephonic outreach to collaborate with treating providers, discussing evidence-based guidelines, closing clinical quality gaps, and care plan adjustments impacting healthcare expenses.
2. Collaborate with operational and business partners on clinical and quality initiatives to meet customer expectations.
3. Apply evidence-based medicine (EBM), such as InterQual care guidelines and criteria reviews.
4. Occasionally participate in market oversight meetings with Chief Medical Officers, network contractors, nurse management, and internal managers.
5. Maintain proficiency in all required software and platforms.

While the work is regionally concentrated, Medical Directors are part of a national team and collaborate across the country with peers, nurse managers, and non-clinical staff. They may also engage in change management and program modifications based on customer needs.

You will be recognized and rewarded for your performance in a challenging environment that provides clear success metrics and career development opportunities.

Required Qualifications

• MD or DO with an active, unrestricted medical license
• Current Board Certification in an ABMS or AOBMS specialty
• 3+ years of clinical practice experience post-residency
• Private home office and high-speed internet access
• Proficiency with relevant software and systems

Preferred Qualifications

• Licensure in HI, AK, OR, ID, WA, UT (a plus)
• 2+ years of managed care, Quality Management, or administrative leadership experience
• Prior Utilization Management experience
• Clinical experience within the past 2 years
• Adherence to UnitedHealth Group’s Telecommuter Policy for remote employees

For residents of California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, D.C.: The salary range is $286,104 to $397,743 annually, based on experience, education, location, and other factors. Benefits include comprehensive healthcare, incentive programs, stock options, and 401k contributions. All benefits are subject to eligibility.

Application Deadline: The posting remains open for at least 2 business days or until a sufficient candidate pool is reached. The posting may close early if filled.

At UnitedHealth Group, our mission is to help people live healthier lives and improve the health system. We are committed to diversity, equity, and inclusion, addressing health disparities, and delivering equitable care.

We are an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration without regard to race, gender, age, disability, or other protected characteristics. We are a drug-free workplace requiring pre-employment drug testing.