Inpatient Care Management Medical Director - Remote

UnitedHealth Group•Tampa, FL

3d•$248,500 - $440,500•Remote

About The Position

Optum is seeking an Inpatient Care Management Medical Director to join their team. This role focuses on conducting acute level of care and length of stay reviews for medical necessity for members within the continuum of care. The team serves clients including local and national commercial employers, Medicare, and state Medicaid plans. Medical Directors collaborate with nurses and support staff to manage inpatient care utilization at various levels (hospital, market, regional, or national). The position offers the flexibility to work remotely from anywhere within the U.S. The work involves participating in telephonic outreach with treating providers to discuss evidence-based guidelines, clinical quality/service gaps, and care plan changes impacting healthcare expenses. Collaboration with operational and business partners on clinical and quality initiatives is key. The role is grounded in the use of evidence-based medicine, such as InterQual care guidelines. Occasional participation in market oversight meetings with Chief Medical Officers, network contractors, and management is expected. The role also includes rotational holiday and call coverage and maintaining proficiency in required software. While the work is typically regional, the Medical Director is part of a national organization and collaborates with peers and staff across the country. There are opportunities to be involved in change design and management in response to customer needs. The company offers a rewarding and challenging environment with clear direction and development opportunities.

Requirements

MD or DO with an active, unrestricted medical license
Current Board Certification in an ABMS or AOA specialty
3+ years of clinical practice experience post residency
Technical proficiency in computer software and systems
Private home office and access to high-speed Internet
Participate in rotational holiday and call coverage

Nice To Haves

2+ years of managed care, Quality Management experience and/or administrative leadership experience
UM experience
Clinical experience within the past 2 years

Responsibilities

Participate in telephonic outreach for collaboration with treating providers, discussing evidence-based guidelines, opportunities to close clinical quality/service gaps, and care plan changes that can impact health care expenses.
Collaborate with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations.
Utilize and apply evidence-based medicine (EBM) such as 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.
Participate in rotational holiday and call coverage.
Maintain proficiency in all required software and platforms.