Transforming Healthcare through Innovative Care Transitions
At Optum Home & Community Care, part of the UnitedHealth Group family of businesses, we're revolutionizing healthcare by uniting industry-leading solutions to create an integrated care model. This model holistically addresses an individual's physical, mental, and social needs, enabling patients to access and navigate care anytime, anywhere. As a Medical Director - Post-Acute Care Management - Care Transitions, you'll play a pivotal role in shaping the future of healthcare delivery from hospital to home, supporting patients as they transition across care settings.
About naviHealth and Care Transitions
naviHealth, a part of Optum Home & Community Care, is dedicated to making a positive and powerful impact on society by transforming healthcare. With almost two decades of experience in care transition solutions, we've established ourselves as a leader in this field. Our mission is to work with talented individuals who share our passion for changing healthcare one patient at a time. We're committed to creating a seamless health journey for patients across care settings and are looking for a Medical Director to join our team.
Key Responsibilities
- Provide daily utilization oversight and external communication with network physicians and hospitals, ensuring effective care transitions.
- Conduct daily UM reviews, including authorizations and denial reviews, to ensure clinically appropriate care.
- Engage in peer-to-peer conversations for clinical case reviews as needed, promoting collaborative decision-making.
- Conduct provider telephonic reviews and discussions, 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 the 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 external levels, identifying, engaging, and establishing relationships with thought leaders.
- Collaborate with the 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.
- 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 network and provider contracting.
- Regularly meet with Care Transitions' leadership to review care coordination issues and develop collaborative intervention plans.
- Provide input on local needs for the Analytics Team and Client Services Team to enhance Care Transitions' products and services.
- Ensure appropriate management and resolution of local queries regarding patient case management.
- Participate on the Medical Advisory Board, providing medical expertise and guidance.
- Perform other duties and responsibilities as required, assigned, or requested.
Qualifications and Requirements
Essential Qualifications
- Board certification as an MD, DO, or 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 experience, preferably in an inpatient or post-acute setting.
Preferred Qualifications
- Licensure in multiple states or willingness 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.
- Proven excellent organizational, analytical, verbal, and written communication skills.
- Proven solid interpersonal skills with the ability to communicate and build positive relationships with colleagues.
- Demonstrated competence in the use of electronic health records and associated technology and applications.
What We Offer
As a Medical Director - Post-Acute Care Management - Care Transitions, you'll be rewarded and recognized for your performance in an environment that challenges you and provides clear direction on what it takes to succeed. You'll enjoy a competitive salary, comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements). Our remote work arrangement offers flexibility and the opportunity to work from anywhere within the U.S.
Compensation and Benefits
The salary range for this role is $286,104 to $397,743 per year, with a pay mix of base and bonus variable based on experience and metric achievement. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, you'll receive a comprehensive benefits package, including incentive and recognition programs, equity stock purchase, and 401k contribution.
Company Culture and Values
At UnitedHealth Group, we're committed to helping people live healthier lives and making the health system work better for everyone. We believe in diversity, equity, and inclusion, and we're dedicated to mitigating our impact on the environment. As an Equal Employment Opportunity/Affirmative Action employer, we welcome applications from diverse candidates and provide 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.
Join Our Team
If you're a motivated and experienced Medical Director looking to make a difference in healthcare, we encourage you to apply now. As a leader in post-acute care management and care transitions, you'll have the opportunity to shape the future of healthcare delivery and contribute to our mission of helping people live healthier lives. Apply today and join our team in transforming healthcare!
Apply Now