Inpatient Care Management, Medical Director licensed in MO - Remote in MO

UnitedHealth Group•St. Louis, MO

1d•$248,500 - $373,000•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 clients include commercial employer, 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 primary responsibilities include telephonic outreach for collaboration with treating providers to discuss evidence-based guidelines, opportunities to close clinical quality/service gaps, and care plan changes impacting healthcare expenses. The role also involves collaborating with operational and business partners on clinical and quality initiatives, utilizing evidence-based medicine (EBM) such as InterQual care guidelines, and occasionally participating in market oversight meetings. The Medical Director will also participate in rotational holiday and call coverage and maintain proficiency in required software. While typically concentrated in a region, the role is part of a national organization, requiring collaboration with peers and staff across the country. There are opportunities for involvement in change design and management for those interested. The company emphasizes rewarding and recognizing performance in a challenging environment with clear direction and development opportunities for other roles.

Requirements

MD or DO with an active, unrestricted medical license in the state of Missouri.
Reside in Missouri.
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.
Adherence to UnitedHealth Group’s Telecommuter Policy for all remote employees.

Nice To Haves

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

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 healthcare 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 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.
Collaborate with peers, nurse managers, and non-clinical employees from across the country.
Potentially be involved with change design and management in response to customer needs and expectations.