Medical Director - Post-Acute Care Management - Optum Care Transitions - Remote

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.

Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 6 industry leader.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Work to improve quality and promote evidence-based medicine
• Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement
• Support initiatives that enhance quality throughout our national network
• Ensure the right service is provided at the right time for each member
• Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review
• Success in this technology-heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production-driven setting

Required Qualifications:

• MD or DO degree
• Active, unrestricted Physician license
• Current Board Certification in ABMS or AOA specialty
• 5+ years of clinical practice experience post residency
• 3+ years of patient care experience, post-residency
• Proven solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles

Preferred Qualifications

• Hands-on utilization and/or quality management experience

• Project management or active project participation experience

• Substantial experience in using electronic clinical systems