Medical Director - Post-Acute Care Management

Caring. Connecting. Growing Together. Join Optum, a global leader dedicated to enhancing health through innovative technology and compassionate care. As part of our team, you will play a crucial role in improving health outcomes for millions, providing access to vital care and resources. Experience a culture founded on inclusivity, with talented peers and abundant opportunities for professional growth. Help us make a meaningful impact as we advance health optimization globally. Why Care Transitions? Our mission at Care Transitions is to collaborate with exceptionally talented individuals committed to transforming healthcare for the better. With nearly two decades of visionary leadership and groundbreaking organizations, we are redefining care transitions one patient at a time. We thrive on innovation and have a genuine enthusiasm for progress within a dynamic, technology-driven environment. Enjoy the flexibility to work remotely while tackling complex challenges. We are seeking Medical Directors available during daytime hours in any continental U.S. time zone. Primary Responsibilities: Oversee daily utilization and communicate with network physicians and hospitals. Conduct daily Utilization Management (UM) reviews including authorizations and denial evaluations. Engage in peer-to-peer discussions for clinical case reviews when necessary. Provide telephonic consultations to providers, sharing resources related to cost-effective healthcare and quality standards. Foster effective communication with both network and non-network providers to ensure smooth delivery of Care Transitions services. Serve as a non-promotional medical liaison for clinical inquiries from healthcare providers. Represent Care Transitions in external forums, fostering relationships with industry thought leaders. Collaborate with the Client Services Team to ensure coordinated care with service providers. Contribute to action plans aimed at implementing strategic initiatives and monitoring progress. Engage with community physicians, hospital leaders, and vendors regarding patient care and services. Lead and advise on maximizing cost management in coordination with network and provider contracting. Participate in regular meetings with Care Transitions leadership to address care coordination issues and share insights. Provide feedback to the Analytics and Client Services Teams to enhance Care Transitions offerings. Manage inquiries related to patient case management efficiently. Participate in the Medical Advisory Board. Provide scheduled weekend and evening coverage as needed. Fulfill additional responsibilities as required. You will be recognized and rewarded for your contributions in a supportive environment that challenges you and provides clear guidance for success in your role while also facilitating your development for future opportunities. Required Qualifications: Unrestricted medical license with the ability to acquire licenses in multiple states. Board certification as an MD, DO, or MBBS, with maintenance of necessary credentials. A minimum of 3 years post-residency experience in patient care, ideally in inpatient or post-acute settings. Preferred Qualifications: Multi-state licensure. Desire to obtain additional state licenses, supported by Optum. Knowledge of population-based medicine, especially CMS criteria for post-acute care. Proven ability to work collaboratively while managing multiple tasks. Capacity to operate independently with minimal supervision. Strong interpersonal skills to engage positively with clinicians and other professionals. Experience with electronic health records and associated technologies. Excellent organizational, analytical, verbal, and written communication skills. Integrity, professionalism, and motivation to adapt in a fast-paced environment. Compensation for this role typically ranges from $238,000 to $357,500, incorporating base pay and bonuses, influenced by local labor markets, education, and experience. In addition to competitive pay, we offer a comprehensive benefits package, including recognition programs, equity stock purchase, and 401(k) contributions (benefits subject to eligibility criteria). Discover a wide array of benefits tailored to support you. At UnitedHealth Group, we strive to help individuals live healthier lives, ensuring the health system functions effectively for everyone. We advocate for equitable healthcare, addressing disparities faced by marginalized groups, reflecting our commitment to improvement. UnitedHealth Group is an Equal Employment Opportunity employer, and all qualified applicants will be considered without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, veteran status, or any other characteristic protected by law. UnitedHealth Group operates a drug-free workplace. Candidates must pass a drug test prior to employment.