[Hiring] Inpatient Care Management Medical Director @UnitedHealth Group

Role Description

We are currently seeking an Inpatient Care Management Medical Director to join our Optum team in Missouri. This team is responsible for conducting acute level of care and length of stay reviews for medical necessity for our members being managed within the continuum of care. Our clients include local and national commercial employers, Medicare, and state Medicaid plans. The Medical Directors work with groups of nurses and support staff to manage inpatient care utilization at a hospital, market, regional or national level.

You’ll enjoy the flexibility to work remotely from anywhere in the state of Missouri as you take on some tough challenges.

Primary 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.
• Grounded in the use and application of evidence-based medicine (EBM) such as InterQual care guidelines and criteria review.
• Occasionally participate in periodic market oversight meetings with the outward facing Chief Medical Officers, network contractors, nurse management, and other internal managers.
• Maintain proficiency in all required software and platforms.

Qualifications

• MD or DO with an active, unrestricted medical license in the state of 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.
• Ability to participate in rotational holiday and call coverage.
• Reside in the state of Missouri.

Requirements

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

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).

Company Description

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable, and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard, and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences, and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.