Optum
Director of Medical Services - Post-Acute Care Management
Optum - Chicago, Illinois, United States, 60290
Work at Optum
Overview
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Overview
At Optum Home & Community Care, a part of the UnitedHealth Group family of businesses, we are pioneering a transformative approach in health care. By integrating leading-edge solutions, we are creating a holistic care model that addresses the comprehensive needs of individuals—physical, mental, and social—so patients can access and navigate care seamlessly, anytime and anywhere.
As a vital member of our naviHealth product team, you will play a key role in revolutionizing patient care from hospital to home, supporting individuals in their transitions across various care settings. This impactful work is designed to provide older adults with more days at home.
Join us in our mission to
Care, Connect, and Grow together. Why Choose naviHealth? At naviHealth, we are dedicated to working with exceptionally talented individuals who are passionate about making a substantial positive impact on society by transforming health care. With almost two decades of visionary leadership and innovative organizations, we proudly challenge the status quo of care transition solutions. Our unique approach to health care changes the lives of patients, one individual at a time. We are looking for energized and growth-oriented team members who thrive in a dynamic environment, utilizing the latest technologies aligned with our strategic vision. You will enjoy the flexibility to work remotely from anywhere within the U.S. while tackling significant challenges. We are currently seeking Medical Directors who can operate during daytime hours across all continental U.S. time zones. Key Responsibilities: Provide daily oversight of utilization and facilitate external communication with network physicians and hospitals. Conduct daily utilization management (UM) reviews, including authorizations and denial assessments. Engage in peer-to-peer conversations for clinical case reviews as necessary. Conduct telephonic reviews and discussions with providers, sharing tools, information, and guidelines related to cost-effective healthcare delivery and quality of care. Ensure effective communication with both network and non-network providers to successfully administer Care Transitions' services. Act as a non-promotional medical contact point for various healthcare providers, responding to clinical inquiries. Represent Care Transitions at external levels, fostering relationships with thought leaders in the field. Collaborate with the Client Services Team to ensure a cohesive approach to delivering services to providers. Assist in developing action plans and strategies to address operational concerns and track progress towards goals. Interact and collaborate with network and community physicians, hospital leaders, and vendors regarding care and services for patients. Provide leadership to maximize cost management through close coordination with provider contracting. Meet regularly with Care Transitions' leadership to review care coordination issues and develop collaborative intervention plans. Provide insights to the Analytics Team and Client Services Team to enhance Care Transitions' products and services. Manage and resolve local queries regarding patient case management, either directly or by routing them to specialists. Participate in the Medical Advisory Board. Provide intermittent weekend and evening coverage as required. Perform other duties and responsibilities as needed. You will be rewarded and recognized for your performance in an environment that is designed to challenge you whilst providing clear direction for success in your role and opportunities for professional development. Required Qualifications: Board certification as an MD, DO, or MBBS, with a current unrestricted license to practice, ready to maintain necessary credentials. Ability to obtain licensure in multiple states. Remote work enabled across the U.S. At least 3 years of post-residency patient care experience, preferably in inpatient or post-acute settings. Preferred Qualifications: Licensure in multiple states and willingness to obtain further state licenses with support from Optum. Understanding of population-based medicine and familiarity with CMS criteria for post-acute care. Demonstrated ability to work collaboratively within a team while managing multiple tasks. Ability to complete assignments with moderate oversight and supervision. Exceptional interpersonal skills that allow for effective communication with clinicians and medical professionals. Proficiency in the use of electronic health records and related technology. Strong organizational, analytical, verbal, and written communication skills. High ethical standards and integrity. Proactive, adaptable, and able to thrive in a fast-paced and changing environment. All remote employees are required to adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $238,000 to $357,500 per year. Salary is defined as total cash compensation at target and is variable based on experience and performance metrics. Pay is influenced by factors including local labor markets, education, work experience, and certifications. UnitedHealth Group adheres to all applicable minimum wage laws. Our benefits package, which includes healthcare options, stock purchase plans, and 401k contributions, is comprehensive and contingent on eligibility requirements, providing a substantial value alongside your salary. Application Deadline:
This posting will remain open for a minimum of 2 business days or until we collect a sufficient candidate pool. It may be removed early given the volume of applicants. At UnitedHealth Group, we are committed to helping individuals lead healthier lives and improving the health system for everyone. We believe that everyone—regardless of race, gender, sexuality, age, location, or income—deserves the opportunity to live their healthiest life. We recognize that numerous barriers to good health still exist, disproportionately impacting communities of color and historically marginalized groups. We aim to address these disparities and enhance health outcomes through equitable care, a priority evident in our mission. UnitedHealth Group is an Equal Employment Opportunity employer, and qualified applicants will be considered for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, veteran status, or any other characteristic protected by local, state, or federal laws. UnitedHealth Group maintains a drug-free workplace policy. Candidates must pass a drug test prior to commencing employment.
Care, Connect, and Grow together. Why Choose naviHealth? At naviHealth, we are dedicated to working with exceptionally talented individuals who are passionate about making a substantial positive impact on society by transforming health care. With almost two decades of visionary leadership and innovative organizations, we proudly challenge the status quo of care transition solutions. Our unique approach to health care changes the lives of patients, one individual at a time. We are looking for energized and growth-oriented team members who thrive in a dynamic environment, utilizing the latest technologies aligned with our strategic vision. You will enjoy the flexibility to work remotely from anywhere within the U.S. while tackling significant challenges. We are currently seeking Medical Directors who can operate during daytime hours across all continental U.S. time zones. Key Responsibilities: Provide daily oversight of utilization and facilitate external communication with network physicians and hospitals. Conduct daily utilization management (UM) reviews, including authorizations and denial assessments. Engage in peer-to-peer conversations for clinical case reviews as necessary. Conduct telephonic reviews and discussions with providers, sharing tools, information, and guidelines related to cost-effective healthcare delivery and quality of care. Ensure effective communication with both network and non-network providers to successfully administer Care Transitions' services. Act as a non-promotional medical contact point for various healthcare providers, responding to clinical inquiries. Represent Care Transitions at external levels, fostering relationships with thought leaders in the field. Collaborate with the Client Services Team to ensure a cohesive approach to delivering services to providers. Assist in developing action plans and strategies to address operational concerns and track progress towards goals. Interact and collaborate with network and community physicians, hospital leaders, and vendors regarding care and services for patients. Provide leadership to maximize cost management through close coordination with provider contracting. Meet regularly with Care Transitions' leadership to review care coordination issues and develop collaborative intervention plans. Provide insights to the Analytics Team and Client Services Team to enhance Care Transitions' products and services. Manage and resolve local queries regarding patient case management, either directly or by routing them to specialists. Participate in the Medical Advisory Board. Provide intermittent weekend and evening coverage as required. Perform other duties and responsibilities as needed. You will be rewarded and recognized for your performance in an environment that is designed to challenge you whilst providing clear direction for success in your role and opportunities for professional development. Required Qualifications: Board certification as an MD, DO, or MBBS, with a current unrestricted license to practice, ready to maintain necessary credentials. Ability to obtain licensure in multiple states. Remote work enabled across the U.S. At least 3 years of post-residency patient care experience, preferably in inpatient or post-acute settings. Preferred Qualifications: Licensure in multiple states and willingness to obtain further state licenses with support from Optum. Understanding of population-based medicine and familiarity with CMS criteria for post-acute care. Demonstrated ability to work collaboratively within a team while managing multiple tasks. Ability to complete assignments with moderate oversight and supervision. Exceptional interpersonal skills that allow for effective communication with clinicians and medical professionals. Proficiency in the use of electronic health records and related technology. Strong organizational, analytical, verbal, and written communication skills. High ethical standards and integrity. Proactive, adaptable, and able to thrive in a fast-paced and changing environment. All remote employees are required to adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $238,000 to $357,500 per year. Salary is defined as total cash compensation at target and is variable based on experience and performance metrics. Pay is influenced by factors including local labor markets, education, work experience, and certifications. UnitedHealth Group adheres to all applicable minimum wage laws. Our benefits package, which includes healthcare options, stock purchase plans, and 401k contributions, is comprehensive and contingent on eligibility requirements, providing a substantial value alongside your salary. Application Deadline:
This posting will remain open for a minimum of 2 business days or until we collect a sufficient candidate pool. It may be removed early given the volume of applicants. At UnitedHealth Group, we are committed to helping individuals lead healthier lives and improving the health system for everyone. We believe that everyone—regardless of race, gender, sexuality, age, location, or income—deserves the opportunity to live their healthiest life. We recognize that numerous barriers to good health still exist, disproportionately impacting communities of color and historically marginalized groups. We aim to address these disparities and enhance health outcomes through equitable care, a priority evident in our mission. UnitedHealth Group is an Equal Employment Opportunity employer, and qualified applicants will be considered for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, veteran status, or any other characteristic protected by local, state, or federal laws. UnitedHealth Group maintains a drug-free workplace policy. Candidates must pass a drug test prior to commencing employment.