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Inpatient Care Management Medical Director - Missouri residence - Remote

Inpatient Care Management Medical Director - Missouri residence - Remote

UnitedHealth GroupSt. Louis, MO, United States
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Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

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.

If you are located in Missouri, you will have the flexibility to work remotely

  • as you take on some tough challenges.

Primary Responsibilities :

  • Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expenses
  • Responsible for collaborating 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, may 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
  • 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 :

  • MD or DO with an active, unrestricted medical license in the state of Missouri
  • Current Board Certification in Family Medicine, Internal Medicine-Pediatrics, Emergency Medicine or Internal Medicine with pediatric experience
  • 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
  • Preferred Qualifications :

  • 2+ years of managed care, Quality Management experience and / or administrative leadership experience
  • UM experience
  • Clinical experience within the past two years
  • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
  • Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives.

    At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

    UnitedHealth Group is 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 is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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    Director Care Management • St. Louis, MO, United States

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