MEDICAL DIRECTOR - POST-ACUTE CARE MANAGEMENT - CARE TRANSITIONS - REMOTE
Company: UnitedHealth Group
Location: Los Angeles
Posted on: October 22, 2024
Job Description:
Optum Home & Community Care, part of the UnitedHealth Group
family of businesses, is creating something new in health care. We
are uniting industry-leading solutions to build an integrated care
model that holistically addresses an individual's physical, mental
and social needs - helping patients access and navigate care
anytime and anywhere.As a team member of our naviHealth product, we
help change the way health care is delivered from hospital to home
supporting patients transitioning across care settings. This
life-changing work helps give older adults more days at home.We're
connecting care to create a seamless health journey for patients
across care settings. Join us to start Caring. Connecting. Growing
together.Why naviHealth?At naviHealth, our mission is to work with
extraordinarily talented people who are committed to making a
positive and powerful impact on society by transforming health
care. naviHealth is the result of almost two decades of dedicated
visionary leaders and innovative organizations challenging the
status quo for care transition solutions. We do health care
differently and we are changing health care one patient at a time.
Moreover, have a genuine passion and energy to grow within an
aggressive and fun environment, using the latest technologies in
alignment with the company's technical vision and strategy.You'll
enjoy the flexibility to work remotely * from anywhere within the
U.S. as you take on some tough challenges. We are currently looking
for Medical Directors that can work daytime in any of the
continental time zones in the US.Primary Responsibilities:
- Provide daily utilization oversight and external communication
with network physicians and hospitals
- Daily UM reviews - authorizations and denial reviews
- Conduct peer to peer conversations for the clinical case
reviews, as needed
- Conduct provider telephonic review and discussion and share
tools, information, and guidelines as they relate to cost-effective
healthcare delivery and quality of care
- Communicate effectively with network and non-network providers
to ensure the successful administering 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/maintaining 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, communicate, and collaborate 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
- Providing intermittent, scheduled weekend and evening
coverage
- Perform other duties and responsibilities as required,
assigned, or requestedYou'll be rewarded and recognized for your
performance in an environment that will challenge you and give you
clear direction on what it takes to succeed in your role as well as
provide development for other roles you may be interested
in.Required Qualifications:
- Board certification as an MD, DO, MBBS with a current
unrestricted license to practice and maintain necessary credentials
to retain the position
- 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 settingPreferred Qualifications:
- Licensure in multiple states
- Willing to obtain additional state licenses, with Optum's
support
- 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
- Demonstrated competence in use of electronic health records as
well as 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*All employees working remotely will
be required to adhere to UnitedHealth Group's Telecommuter
PolicyCalifornia, Colorado, Connecticut, Hawaii, Nevada, New
Jersey, New York, Rhode Island, Washington or Washington, D.C.
Residents Only: The salary range for this role is $286,104 to
$397,743 annually. Salary Range is defined as total cash
compensation at target. The actual range and pay mix of base and
bonus is variable based upon experience and metric achievement. Pay
is based on several factors including but not limited to local
labor markets, education, work experience, certifications, etc.
UnitedHealth Group complies with all minimum wage laws as
applicable. In addition to your salary, UnitedHealth Group offers
benefits such as, a comprehensive benefits package, incentive and
recognition programs, equity stock purchase and 401k contribution
(all benefits are subject to eligibility requirements). No matter
where or when you begin a career with UnitedHealth Group, you'll
find a far-reaching choice of benefits and incentives.Application
Deadline: This will be posted for a minimum of 2 business days or
until a sufficient candidate pool has been collected. Job posting
may come down early due to volume of applicants.At UnitedHealth
Group, our mission is to help people live healthier lives and make
the health system work better for everyone. We believe everyone-of
every race, gender, sexuality, age, location and income-deserves
the opportunity to live their healthiest life. Today, however,
there are still far too many barriers to good health which are
disproportionately experienced by people of color, historically
marginalized groups and those with lower incomes. We are committed
to mitigating our impact on the environment and enabling and
delivering equitable care that addresses health disparities and
improves health outcomes - an enterprise priority reflected in our
mission.Diversity creates a healthier atmosphere: UnitedHealth
Group is an Equal Employment Opportunity/Affirmative Action
employer and 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.
Keywords: UnitedHealth Group, Escondido , MEDICAL DIRECTOR - POST-ACUTE CARE MANAGEMENT - CARE TRANSITIONS - REMOTE, Executive , Los Angeles, California
Didn't find what you're looking for? Search again!
Loading more jobs...