Medical Director (Utilization Management)

WellSky; United States; Remote; USD 230,000 - 350,000; Full time

Benefits offered by this job

Excellent medical benefits

Mental Health support (EAP)

PTO and holidays

100% vested 401(k)

Educational assistance

Job summary

WellSky is seeking a Medical Director for remote oversight of clinical management across acute, ED, post-acute care programs. The role blends medical leadership, care coordination, and strategic program improvements. Location flexibility is offered with proximity to Overland Park, KS for optional in-office collaboration.

The position requires a Doctoral degree, active MD/DO license, 6–8 years of experience, and board certification in a relevant specialty. Travel up to 10% may be required.

Qualifications

• Doctoral degree in a relevant medical field.
• Active, unrestricted medical license (MD or DO).
• Board certification in a relevant specialty (PM&R, Internal Medicine, Emergency Medicine, or General Surgery).

Responsibilities

• Lead improvements of post-acute clinical programs by driving strategy, design, and implementation.
• Provide timely expert medical review for acute (ED) and post-acute care services (SNF, IRF, LTACH, HH).
• Document clinical review findings, actions, and outcomes per policy and regulatory requirements.
• Provide guidance for clinical operational aspects of the ED, acute, and post-acute care programs.
• Collaborate with acute ED providers to coordinate and/or support care transitions.
• Identify and develop opportunities for innovation to increase effectiveness and quality, including education development, training, and issue resolution.
• Participate in client JOCs or partner/stakeholder meetings as needed.
• Perform other job duties as assigned.

Skills

Clinical leadership

Medical review

Strategic planning

Collaboration

Education

MD/DO

Job description

The Medical Director is responsible for providing oversight, medical guidance and support to the full spectrum of WellSky's clinical management acute, emergency department, and post-acute care solutions and programs. The scope of this job includes providing expertise and leadership in medical management, as well as care coordination activities for acute and post-acute care services. Location: This is a remote position. Candidates located within 50 miles of WellSky's headquarters in Overland Park, KS will join our WHQ community and participate in our in-office collaboration experience.

Key Responsibilities

• Lead improvements of post-acute clinical programs by driving strategy, design, and implementation.
• Provide timely expert medical review for acute (ED) and post-acute care services (SNF, IRF, LTACH, HH), provide a clinical opinion about the medical service under review (including post-decision reviews), and be available for escalations from the nurse teams.
• Document clinical review findings, actions, and outcomes per policy and in accordance with regulatory and accreditation requirements.
• Provide guidance for clinical operational aspects of the ED, acute, and post-acute care programs.
• Collaborate with acute ED providers to coordinate and/or support care transitions.
• Identify and develop opportunities for innovation to increase effectiveness and quality, including education development, training, and issue resolution.
• Participate in client JOCs or partner/stakeholder meetings as needed.
• Perform other job duties as assigned.

Required Qualifications

• Doctoral degree in a relevant medical field
• At least 6-8 years of relevant work experience
• Active, unrestricted medical license (MD or DO)
• Board certification in a relevant specialty (preferably in Physical Medicine and Rehabilitation, Internal Medicine, Emergency Medicine, or General Surgery)

Job Expectations

• Willing to travel up to 10% based on business needs
• Willing to work additional or irregular hours as needed
• Must work in accordance with applicable security policies and procedures to safeguard company and client information
• Must be able to sit and view a computer screen for extended periods of time #LI-OF1 #LI-Remote

WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky:

• Excellent medical with Rx, dental, and vision benefits
• Mental Health support through EAP
• Generous paid time off, plus 13 paid holidays
• 100% vested 401(K) retirement plans
• Educational assistance up to $2500 per year

WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law.

WellSky is proud to be a drug-free workplace.

Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.

Data Privacy Notice for Job Applicants and Teammates

WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next-level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.