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

Lensa; Bethesda (MD); Remote; USD 238,000 - 358,000; Full time

Job summary

A leading health care organization is seeking a Medical Director specializing in post-acute care management. The role involves overseeing utilization, collaborating with providers, and enhancing patient care transitions. Ideal candidates will have board certification and extensive patient care experience. This position offers flexibility to work remotely across the U.S., with a competitive salary and comprehensive benefits.

Benefits

Comprehensive Benefits Package

Incentives

Stock Options

401k Contributions

Qualifications

• At least 3 years of post-residency patient care experience.
• Current medical license and ability to obtain multi-state licensure.

Responsibilities

• Provide daily utilization oversight and communicate with network physicians.
• Conduct utilization management reviews, including authorizations and denials.
• Engage in provider telephonic reviews and share guidelines for quality care.

Skills

Communication

Organizational Skills

Interpersonal Skills

Ethics

Education

Board certification (MD, DO, MBBS)

Tools

Electronic Health Records

Job description

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

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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 Home & Community Care, part of the UnitedHealth Group family of businesses, is creating innovative health care solutions. We are building an integrated care model that addresses physical, mental, and social needs, helping patients access care anytime and anywhere.

As part of our Care Transitions (naviHealth) product, we aim to change health care delivery by supporting patients transitioning from hospital to home, enabling more days at home for older adults.

We’re connecting care to create a seamless health journey across settings. Join us to start Caring. Connecting. Growing together.

Why Care Transitions?

Our mission is to work with talented individuals committed to transforming health care. With nearly two decades of leadership and innovation, we challenge the status quo for care transition solutions, doing health care differently and making a difference one patient at a time. We value passion, energy, and growth within a dynamic environment, leveraging the latest technologies aligned with our strategic vision.

You’ll have the flexibility to work remotely from anywhere in the U.S., with daytime hours in any continental time zone.

Primary Responsibilities

1. Provide daily utilization oversight and communicate with network physicians and hospitals
2. Conduct utilization management reviews, including authorizations and denials
3. Perform peer-to-peer clinical case reviews as needed
4. Engage in provider telephonic reviews, sharing tools and guidelines for cost-effective, quality care
5. Communicate effectively with providers to administer Care Transitions’ services
6. Respond to clinical inquiries, serving as a non-promotional medical contact
7. Represent Care Transitions externally, establishing relationships with thought leaders
8. Collaborate with the Client Services Team on strategic initiatives
9. Contribute to action plans for care improvement and monitor progress
10. Interact with physicians, hospital leaders, and vendors regarding patient care
11. Provide leadership to optimize cost management through network and provider coordination
12. Meet regularly with leadership to review care coordination and network issues
13. Provide input for analytics and product enhancement
14. Manage local queries on patient case management
15. Participate on the Medical Advisory Board
16. Provide scheduled weekend and evening coverage as needed
17. Perform additional duties as assigned

Required Qualifications

• Board certification (MD, DO, 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

• Licensure in multiple states and willingness to obtain additional licenses with company support
• Knowledge of population-based medicine and CMS criteria for post-acute care
• Ability to work collaboratively and manage multiple tasks
• Proficiency with electronic health records and related technology
• Excellent organizational, communication, and interpersonal skills
• Strong ethics and integrity
• Motivated, flexible, and adaptable in a fast-paced environment

The annual salary range is $238,000 to $357,500, based on experience, location, and other factors. Benefits include comprehensive packages, incentives, stock options, and 401k contributions. All employees must adhere to UnitedHealth Group’s telecommuting policies.