Medical Director - Post-Acute Care Management - Care Transitions - Remote

UnitedHealth Group; Baltimore (MD); Remote; USD 286,000 - 398,000; Full time

Job summary

A healthcare company is seeking a qualified medical professional to oversee care transitions, ensuring effective communication with providers and patients. Candidates must have board certification and at least 3 years of patient care experience. This role offers remote work flexibility and a competitive salary package ranging from $286,104 to $397,743 annually, alongside comprehensive benefits.

Benefits

Comprehensive benefits package

Equity stock purchase

401k contribution

Qualifications

• Board certification as an MD, DO, MBBS.
• Current, unrestricted medical license to practice.
• 3+ years of post-residency patient care experience.

Responsibilities

• Provide daily utilization oversight and communication.
• Conduct daily utilization management reviews and authorizations.
• Collaborate with Client Services Team for coordinated care.

Skills

Board certification as an MD, DO, or MBBS

Current, unrestricted medical license

3+ years of post-residency patient care

Understanding of population-based medicine

Proficient in electronic health records

Excellent communication skills

Solid interpersonal skills

Education

Board certification

Job description

Overview

Optum Home & Community Care, part of UnitedHealth Group, is building an integrated care model that holistically addresses an individual's physical, mental and social needs. As a member of the naviHealth product, you will help transition older adults from hospital to home, ensuring they spend more days at home.

Responsibilities

• Provide daily utilization oversight and external communication with network physicians and hospitals.
• Conduct daily utilization management reviews, authorizations and denial reviews.
• Perform peer-to-peer conversations for clinical case reviews as needed.
• Conduct provider telephone review and discussion, sharing tools, information and guidelines related to cost-effective healthcare delivery and quality of care.
• Communicate effectively with network and non-network providers to ensure successful administration 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 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 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.
• Provide intermittent, scheduled weekend and evening coverage.
• Perform other duties and responsibilities as required, assigned or requested.

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, with willingness to obtain additional state licenses.
• 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.
• Proficient in use of electronic health records and 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

Remote work flexibility within the U.S. All employees working remotely will adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $286,104 to $397,743 annually, with benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution.

EEO & Diversity

UnitedHealth Group is an Equal Employment Opportunity / affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information or any other characteristic protected by law. UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.