Medical Director - Post-Acute Care Management - Care Transitions - Remote anywhere in US
Company: Optum
Location: Los Angeles
Posted on: May 12, 2025
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Job Description:
Optum Home & Community Care, part of the UnitedHealth Group
family of businesses, is creating something new in health care. We
are uniting industry-leading solutions to build an integrated care
model that holistically addresses an individual's physical, mental
and social needs - helping patients access and navigate care
anytime and anywhere.
As a team member of our naviHealth product, we help change the way
health care is delivered from hospital to home supporting patients
transitioning across care settings. This life-changing work helps
give older adults more days at home.
We're connecting care to create a seamless health journey for
patients across care settings. Join us to start Caring. Connecting.
Growing together.
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. 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.
You'll enjoy the flexibility to work remotely * from anywhere
within the U.S. as you take on some tough challenges. We are
currently looking for Medical Directors that can work daytime in
any of the continental time zones in the US.
Primary Responsibilities:
Provide daily utilization oversight and external communication with
network physicians and hospitals
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 Care Transitions'
services
Respond to clinical inquiries and serve as a non-promotional
medical contact point for various healthcare providers
Represent Care Transitions 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 Care Transitions' 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 Care Transitions' 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
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 willing to maintain necessary credentials
to retain the position
Current, unrestricted medical license and the ability to obtain
licensure in multiple states. You can work from anywhere in the
United States
3+ years of post-residency patient care, preferably in inpatient or
post-acute setting
Preferred Qualifications:
Licensure in multiple states
Willing to obtain additional state licenses, with Optum's
support
Understanding of population-based medicine, preferably with
knowledge of CMS criteria for post-acute care
Demonstrated ability to work within a team environment while
completing multiple tasks simultaneously
Demonstrated ability to complete assignments with reasonable
oversight, direction, and supervision
Demonstrated ability to positively interact with other clinicians,
management, and all levels of medical and non-medical
professionals
Demonstrated competence in use of electronic health records as well
as associated technology and applications
Proven excellent organizational, analytical, verbal and written
communication skills
Proven solid interpersonal skills with ability to communicate and
build positive relationships with colleagues
Proven highest level of ethics and integrity
Proven highly motivated, flexible and adaptable to working in a
fast-paced, dynamic environment
*All employees working remotely will be required to adhere to
UnitedHealth Group's Telecommuter Policy
The salary range for this role is $238,000 to $357,500 per year.
Salary Range is defined as total cash compensation at target. The
actual range and pay mix of base and bonus is variable based upon
experience and metric achievement. Pay is based on several factors
including but not limited to local labor markets, education, work
experience, certifications, etc. UnitedHealth Group complies with
all minimum wage laws as applicable. 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.
Application Deadline: This will be posted for a minimum of 2
business days or until a sufficient candidate pool has been
collected. Job posting may come down early due to volume of
applicants.
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.
Keywords: Optum, Alhambra , Medical Director - Post-Acute Care Management - Care Transitions - Remote anywhere in US, Healthcare , Los Angeles, California
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