Optum
The role involves conducting acute level of care and length of stay reviews for medical necessity within the continuum of care, collaborating with nurses and support staff to manage inpatient care utilization. The Medical Director participates in telephonic outreach with treating providers, collaborates on clinical and quality initiatives, and applies evidence-based medicine guidelines.
Key Responsibilities
- • Participate in telephonic outreach for collaboration with treating providers, including discussion of evidence-based guidelines, opportunities to close clinical quality/service gaps, and care plan changes that can impact health care expenses
- • Collaborate with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations
- • Use and apply evidence-based medicine such as InterQual care guidelines and criteria review
- • Occasionally participate in periodic market oversight meetings with Chief Medical Officers, network contractors, nurse management and other internal managers
- • Participate in rotational holiday and call coverage
- • Maintain proficiency in all required software and platforms
- • Complete all required training within 30 days from start date
Required
- • MD or DO with an active, unrestricted medical license
- • Current Board Certification in an ABMS or AOA specialty
- • 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 complete all required training within 30 days from start date
- • Ability to work a minimum of 10 hours per week
Preferred
- • 2+ years of managed care, quality management experience and/or administrative leadership experience
- • UM experience
- • Clinical experience within the past 2 years
- • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Benefits & Perks
- • Comprehensive benefits package
- • Incentive and recognition programs
- • Equity stock purchase
- • 401k contribution
We are currently seeking a per diem Inpatient Care Management Medical Director to join our Optum team. 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 employer, 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.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. 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
- Collaborate with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations
- Is 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
- Participate in rotational holiday and call coverage
- Maintain proficiency in all required software and platforms
- Complete all required training within 30 days from start date
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
- Current Board Certification in an ABMS or AOA specialty
- 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 complete all required training within 30 days from start date
- Ability to work a minimum of 10 hours per week
- 2+ years of managed care, quality management experience and/or administrative leadership experience
- UM experience
- Clinical experience within the past 2 years
- All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
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.
Keep track of your job search
Save personal notes for each job to track your thoughts, application status, and follow-ups.
Try for freeUpload your resume
Sign up to upload your resume and get AI-powered customization for job applications.
Sign up freePractice your interview
Get AI-powered mock interviews tailored to this Per diem ICM Medical Director - Weekends - Remote role. Upload your resume and practice with real-time voice feedback.
Sign up to practice