Medical Director - Post-Acute Care Management

Join Optum Home & Community Care, part of the UnitedHealth Group family, as we innovate health care delivery. We are developing an integrated care model that effectively addresses the physical, mental, and social needs of individuals, ensuring seamless access to care anytime and anywhere. Be a part of our naviHealth team, where we are transforming care transitions from hospital to home, ultimately helping older adults enjoy more days at home. As we connect care, we are creating a smoother health journey for patients across various settings. Why choose naviHealth? At naviHealth, we are committed to hiring talented individuals who are passionate about transforming health care. With nearly two decades of visionary leadership behind us, we strive to do things differently and make an impact one patient at a time. If you have a genuine enthusiasm for growth in a dynamic and innovative environment, we want you on our team! Enjoy the flexibility of working remotely from anywhere in the U.S., as we tackle challenging issues together. We are currently seeking Medical Directors available for daytime work across the continental U.S. time zones. Key Responsibilities: Oversee daily utilization and communicate with network physicians and hospitals. Conduct daily UM reviews, including authorizations and denial assessments. Engage in peer-to-peer discussions during clinical case reviews as necessary. Facilitate provider telephonic reviews, sharing essential tools and guidelines for effective healthcare delivery. Ensure effective communication with both network and non-network providers to successfully administer Care Transitions services. Act as a medical contact point for various healthcare providers, responding to clinical inquiries. Represent Care Transitions externally, establishing and maintaining relationships with other thought leaders. Collaborate with the Client Services Team for a coordinated approach to provider delivery systems. Contribute to action plans and programs that implement strategic initiatives while monitoring progress towards goals. Interact and collaborate with network and community physicians, hospital leaders, and vendors regarding enrollee care and services. Lead initiatives to maximize cost management with provider contracting. Conduct regular meetings with Care Transitions leadership to address care coordination issues and share innovative ideas. Provide input to the Analytics Team and Client Services Team to enhance Care Transitions' products and services. Manage local queries regarding patient case management, directing them to the appropriate experts as needed. Participate in the Medical Advisory Board. Provide occasional weekend and evening coverage as scheduled. Perform additional duties as assigned or requested. We recognize and reward performance within a challenging environment that offers clear direction for your success and growth opportunities for other roles you may be interested in. Required Qualifications: Board certification as an MD, DO, or MBBS with a current unrestricted medical license. 3+ years of post-residency patient care experience, ideally in inpatient or post-acute settings. Preferred Qualifications: Licensure in multiple states. Willingness to obtain additional state licenses with support. Understanding of population-based medicine and CMS criteria for post-acute care. Ability to thrive in a team environment while managing multiple tasks. Strong organizational, analytical, and communication skills. Proven interpersonal skills to foster positive relationships with colleagues. Highly motivated and adaptable to a fast-paced environment. All remote employees are required to adhere to UnitedHealth Group's Telecommuter Policy. Salary Information:

For residents of California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C., the salary range is $286,104 to $397,743 annually. This range is based on factors such as local labor markets, education, work experience, and certifications. At UnitedHealth Group, our mission is to promote healthier lives and reform the health system. We are dedicated to overcoming barriers to health faced by marginalized communities. We aim to deliver equitable care that addresses disparities and improves outcomes. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer. All qualified applicants will be considered without regard to race, color, religion, sex, age, national origin, veteran status, disability status, sexual orientation, gender identity or expression, marital status, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates must pass a drug test prior to employment.