Medical Director, Post-Acute Care Management - US Telecommute
Company: UnitedHealth Group
Location: Nashville
Posted on: June 25, 2022
Job Description:
naviHealth, part of Optum and the UnitedHealth Group family of
businesses, combines the talents of our dedicated staff and
leading-edge technology to deliver compassionate care to seniors
nationwide. With millions of lives touched, we are innovating the
way health care is delivered from hospital to home so seniors can
lead more fulfilling lives. A career with us means making an impact
in the lives of those we serve, including vulnerable populations
who benefit from care that is more efficient, more effective and
more human. Our environment empowers our team members to elevate
our interactions with each other and the experiences we deliver to
our patients, giving them more days at home. Join our team, it's
your chance to improve the lives of millions while doing -your
life's best work.(sm) -Why naviHealth?At naviHealth, our mission is
to work with extraordinarily talented people who are committed to
making a positive and powerful impact on society by transforming
health care. - -naviHealth is the result of almost two decades of
dedicated visionary leaders and innovative organizations
challenging the status quo for care transition solutions. We do
health care differently and we are changing health care one patient
at a time. - -naviHealth is looking to hire a senior-level software
engineer with experience building mission-critical service-oriented
applications. This role is a key-contributor to the organization
and future technologies. - -Successful candidates will possess
proven experience developing and delivering quality software
solutions. Moreover, have a genuine passion and energy to grow
within an aggressive and fun environment, using the latest
technologies in alignment with the company's technical vision and
strategy. -The Medical Director will partner with cross-functional
teams and senior leaders to ensure that naviHealth leads the
industry in innovative health management strategies and is
considered an expert in the field of post-acute care. - The role is
a physician leader with a proven track record of innovation,
achievement of measurable goals, and exceptional clinical
competencies. - They take a proactive approach to the marketplace
and are responsible for continuously reshaping naviHealth's
corporate-wide strategies. -You'll enjoy the flexibility to
telecommute* from anywhere within the U.S. as you take on some
tough challenges. -Primary Responsibilities:
- Provide daily utilization oversight and external communication
with network physicians and hospitals
- Responsible for daily UM reviews - authorizations and denial
reviews
- Conduct peer to peer conversations for the clinical case
reviews, as needed
- Conduct provider telephonic review and discussion and share
tools, information, and guidelines as they relate to cost-effective
healthcare delivery and quality of care
- Communicate effectively with network and non-network providers
to ensure the successful administering of naviHealth's
services
- Respond to clinical inquiries and serve as a non-promotional
medical contact point for various healthcare providers
- Represent naviHealth on appropriate external levels
identifying, engaging and establishing/maintaining relationships
with other thought leaders
- Collaborate with Client Services Team to ensure a coordinated
approach to delivery system providers
- Contribute to the development of action plans and programs to
implement strategic initiatives and tactics to address areas of
concern and monitor progress toward goals
- Interact, communicate, and collaborate with network and
community physicians, hospital leaders and other vendors regarding
care and services for enrollees
- Provide leadership and guidance to maximize cost management
through close coordination with all network and provider
contracting
- Regularly meet with naviHealth's leadership to review care
coordination issues, develop collaborative intervention plans, and
share ideas about network management issues
- Provide input on local needs for Analytics Team and Client
Services Team to better enhance naviHealth's products and
services
- Ensure appropriate management/resolution of local queries
regarding patient case management either by responding directly or
routing these inquiries to the appropriate SME
- Participate on the Medical Advisory Board
- Responsible for providing intermittent, scheduled weekend and
evening coverage
- Perform other duties and responsibilities as required,
assigned, or requested - -You'll be rewarded and recognized for
your performance in an environment that will challenge you and give
you clear direction on what it takes to succeed in your role as
well as provide development for other roles you may be interested
in. -Required Qualifications: - -
- Board certification as an MD, DO, MBBS with a current
unrestricted license to practice and maintain necessary credentials
to retain the position
- Current, unrestricted medical license and the ability to obtain
licensure in multiple states -
- 3+ years of post-residency patient care, preferrably in
inpatient or post-acute setting -Preferred Qualifications:
- Understanding of population-based medicine, preferrably with
knowledge of CMS criteria for post-acute care -
- Licensure in multiple states -
- Willing to obtain additional state licenses, with naviHealth's
support
- Excellent organizational, analytical, verbal and written
communication skills
- Ability to work within a team environment while completing
multiple tasks simultaneously
- Ability to complete assignments with reasonable oversight,
direction, and supervision
- Highly motivated, flexible and adaptable to working in a
fast-paced, dynamic environment
- Solid interpersonal skills with ability to communicate and
build positive relationships with colleagues
- Able to positively interact with other clinicians, management,
and all levels of medical and non-medical professionals
- Highest level of ethics and integrity
- Demonstrated competence in use of electronic health records as
well as associated technology and applications
- Full COVID-19 vaccination is an essential requirement of this
role. UnitedHealth Group will adhere to all -federal, state -and
local regulations as well as all client requirements and will
obtain necessary proof of vaccination prior to -employment to
ensure compliance -Work Conditions and Physical Requirements:
- Using phone and computer in a full day of authorization
reviews, peer to peer discussions, interaction with colleagues,
team members, and management
- Ability to establish a home office workspace
- Ability to manipulate laptop computer (or similar
hardware)
- Ability to view screen and enter data into a laptop computer
(or similar hardware) within a standard period of time
- Ability to communicate including use of cellular phone or
comparable communication device
- Ability to remain stationary for extended time periods (1 - 2
hours) - -To protect the health and safety of our workforce,
patients and communities we serve, UnitedHealth Group and its
affiliate companies require all employees to disclose COVID-19
vaccination status prior to beginning employment. In addition, some
roles and locations require full COVID-19 vaccination, including
boosters, as an essential job function. UnitedHealth Group adheres
to all federal, state and local COVID-19 vaccination regulations as
well as all client COVID-19 vaccination requirements and will
obtain the necessary information from candidates prior to
employment to ensure compliance. Candidates must be able to perform
all essential job functions with or without reasonable
accommodation. Failure to meet the vaccination requirement may
result in rescission of an employment offer or termination of
employment. -Careers at UnitedHealth Group. -We have modest goals:
Improve the lives of others. Change the landscape of health care
forever. Leave the world a better place than we found it. Such
aspirations tend to attract a certain type of person. Crazy
talented. Compassionate. Driven. To these select few, we offer the
global reach, resources and can-do culture of a Fortune 10 company.
We provide an environment where you're empowered to be your best.
We encourage you to take risks. And we offer a world of rewards and
benefits for performance. We believe the most important is the
opportunity to do -your life's best work.(sm) -*All Telecommuters
will be required to adhere to UnitedHealth Group's Telecommuter
Policy. -Colorado, Connecticut or Nevada Residents Only: - The
salary range for Colorado/Connecticut/Nevada residents is $254,600
to $295,200. Pay is based on several factors including but not
limited to education, work experience, certifications, etc. In
addition to your salary, UnitedHealth Group offers benefits such
as, a comprehensive benefits package, incentive and recognition
programs, equity stock purchase and 401k contribution (all benefits
are subject to eligibility requirements). No matter where or when
you begin a career with UnitedHealth Group, you'll find a
far-reaching choice of benefits and incentives. -For more
information on our Internal Job Posting Policy, -. - -Diversity
creates a healthier atmosphere: UnitedHealth Group is an Equal
Employment Opportunity/Affirmative Action employer and all
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, age, national origin,
protected veteran status, disability status, sexual orientation,
gender identity or expression, marital status, genetic information,
or any other characteristic protected by law. - - - - -UnitedHealth
Group is a drug - free workplace. Candidates are required to pass a
drug test before beginning employment. - - - -Job Keywords:
-Post-Acute Care Management Medical Director, -Telecommute,
Telecommuter, Telecommuting, Work at Home, Work from Home,
Remote
Keywords: UnitedHealth Group, Nashville , Medical Director, Post-Acute Care Management - US Telecommute, Executive , Nashville, Tennessee
Didn't find what you're looking for? Search again!
Loading more jobs...