Inpatient Care Management Medical Director - Missouri Residency
About The Position
Optum is seeking an Inpatient Care Management Medical Director to join its team in Missouri. The team conducts acute level-of-care and length-of-stay reviews for medical necessity for members across the continuum of care. Clients include local and national commercial employers, Medicare, and state Medicaid plans. Medical Directors work with nurses and support staff to manage inpatient care utilization at the hospital, market, regional, or national level. The role can be performed remotely from anywhere in Missouri. The Medical Director collaborates with treating providers, operational and business partners, and internal stakeholders on utilization management, clinical quality, and care initiatives. Employees working remotely must follow UnitedHealth Group’s Telecommuter Policy. The role also involves rotational holiday and call coverage.
Requirements
- MD or DO with an active, unrestricted medical license in Missouri.
- Current board certification in an ABMS or AOA specialty.
- At least 3 years of clinical practice experience after residency.
- Technical proficiency in computer software and systems.
- Private home office and access to high-speed Internet.
- Ability to participate in rotational holiday and call coverage.
- Reside in Missouri.
Nice To Haves
- At least 2 years of managed care, Quality Management experience, and/or administrative leadership experience.
- Utilization management experience.
- Clinical experience within the past two years.
Responsibilities
- Participate in telephonic outreach and collaborate with treating providers, including discussing evidence-based guidelines, opportunities to close clinical quality and service gaps, and care plan changes that may affect healthcare expenses.
- Collaborate with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations.
- Apply evidence-based medicine, including InterQual care guidelines and criteria review.
- Occasionally participate in periodic market oversight meetings with outward-facing Chief Medical Officers, network contractors, nurse management, and other internal managers.
- Maintain proficiency in all required software and platforms.
- Participate in rotational holiday and call coverage.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution, subject to eligibility requirements.
- Career development opportunities.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Ph.D. or professional degree
