Medical Director - Post-Acute Care Management - Care Transitions - Remote anywhere in US - 2284923

Primary Care Plus; Washington (District of Columbia); Remote; USD 238,000 - 357,000; Full time

Job summary

Join Primary Care Plus as a Medical Director in Post-Acute Care Management, influencing healthcare delivery from hospital to home. This remote role involves overseeing utilization management, engaging with providers, and leading care transitions to enhance patient outcomes. Ideal candidates will have board certification and significant patient care experience.

Benefits

Comprehensive healthcare

Incentives

Stock options

401(k)

Qualifications

• Board certification as MD, DO, or MBBS with an active, unrestricted license.
• At least 3 years of post-residency patient care experience, preferably in inpatient or post-acute settings.

Responsibilities

• Provide daily utilization oversight and communicate with network physicians and hospitals.
• Conduct utilization management reviews, including authorizations and denials.
• Engage in peer-to-peer clinical case reviews as needed.

Skills

Teamwork

Communication

Professional Ethics

Electronic Health Records Proficiency

Education

Board certification as MD, DO, or MBBS

Current medical license

Job description

Medical Director - Post-Acute Care Management - Care Transitions - Remote anywhere in US - 2284923

Join Primary Care Plus as a Medical Director - Post-Acute Care Management - Care Transitions. We are part of Optum Home & Community Care, creating innovative health care solutions that address physical, mental, and social needs, helping patients access care anytime and anywhere.

As a key team member of our Care Transitions (naviHealth) product, you will influence how health care is delivered from hospital to home, supporting older adults to spend more days at home. We are committed to transforming health care, one patient at a time, in a flexible remote work environment across the US.

Primary Responsibilities

• Provide daily utilization oversight and communicate with network physicians and hospitals
• Conduct utilization management reviews, including authorizations and denials
• Engage in peer-to-peer clinical case reviews as needed
• Discuss clinical cases with providers, sharing tools and guidelines for cost-effective, quality care
• Maintain effective communication with providers to ensure seamless care transitions
• Respond to clinical inquiries and serve as a medical contact for healthcare providers
• Represent Care Transitions externally, building relationships with thought leaders
• Collaborate with Client Services to coordinate system provider efforts
• Develop and monitor strategic action plans and initiatives
• Engage with physicians, hospital leaders, and vendors regarding patient care
• Lead efforts to maximize cost management through provider coordination
• Participate in leadership meetings to review care coordination and network issues
• Provide input for analytics and product enhancements
• Manage local queries related to patient case management
• Participate on the Medical Advisory Board
• Provide scheduled weekend and evening coverage as needed

Required Qualifications

• Board certification as MD, DO, or MBBS with an active, unrestricted license
• Current medical license and ability to obtain multi-state licensure
• At least 3 years of post-residency patient care experience, preferably in inpatient or post-acute settings

Preferred Qualifications

• Multi-state licensure and willingness to obtain additional licenses
• Knowledge of population-based medicine and CMS criteria for post-acute care
• Strong teamwork, communication, electronic health records proficiency, and professional ethics
• Motivated, adaptable, and capable of working in a dynamic environment

The salary range is $238,000 to $357,000 annually, based on experience and performance metrics. Benefits include comprehensive healthcare, incentives, stock options, and 401(k). This role offers flexible remote work across the US, with some scheduled weekend and evening hours.