Welcome Back

Google icon Sign in with Google
OR
I agree to abide by Pharmadaily Terms of Service and its Privacy Policy

Create Account

Google icon Sign up with Google
OR
By signing up, you agree to our Terms of Service and Privacy Policy
Instagram
youtube
Facebook

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

Optum
Optum
3+ years
$269,500 to $425,500
10 April 16, 2025
Job Description
Job Type: Full Time Education: MD/DO/MBBS Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Medical Director – Post-Acute Care Management – Care Transitions – Remote
Requisition Number: 2274015
Job Category: Medical & Clinical Operations
Location: Seattle, WA, US (Remote considered)

Primary Responsibilities:

  • Provide daily utilization oversight and maintain external communication with network physicians and hospitals.

  • Perform daily utilization management (UM) reviews including authorization and denial reviews.

  • Conduct peer-to-peer clinical case reviews and provider telephonic discussions.

  • Share tools, clinical guidelines, and information to support cost-effective, quality healthcare delivery.

  • Serve as a non-promotional clinical resource for healthcare providers and respond to inquiries.

  • Represent Care Transitions externally and maintain relationships with medical thought leaders.

  • Collaborate with Client Services Team for cohesive coordination with delivery system providers.

  • Contribute to strategic initiatives, developing and monitoring action plans to achieve goals.

  • Interact with physicians, hospital leaders, and vendors to coordinate patient care.

  • Provide leadership to maximize cost efficiency and network engagement.

  • Participate in regular leadership meetings to resolve coordination issues and develop interventions.

  • Offer input to Analytics and Client Services Teams for service improvement.

  • Address and manage local patient case inquiries directly or by involving subject matter experts.

  • Participate in the Medical Advisory Board and cover intermittent weekend/evening duties as needed.

  • Perform other responsibilities as assigned.

Required Qualifications:

  • MD, DO, or MBBS degree with current, unrestricted license to practice medicine.

  • Board certification and willingness to maintain credentials.

  • 3+ years of post-residency clinical experience, ideally in inpatient or post-acute care.

  • Ability to obtain licensure in multiple states as required.

Preferred Qualifications:

  • Existing licensure in multiple U.S. states.

  • Understanding of CMS criteria and population-based post-acute care medicine.

  • Experience in team-based environments and multitasking under minimal supervision.

  • Strong interpersonal, communication, and relationship-building skills.

  • Proficiency in electronic health records (EHR) systems and relevant healthcare applications.

  • High standards of ethics, integrity, flexibility, and adaptability in fast-paced environments.

Compensation and Benefits:

  • Salary range: $269,500 to $425,500 annually (based on full-time employment, experience, and performance metrics).

  • Comprehensive benefits including incentive programs, stock purchase options, 401(k) contributions, and more (eligibility requirements apply).

Additional Details:

  • Remote work flexibility within the continental U.S.

  • Must comply with UnitedHealth Group’s Telecommuter Policy.

  • Application will remain open for at least 2 business days or until a sufficient candidate pool is identified.

About the Company:
UnitedHealth Group is committed to helping people live healthier lives and to improving the health system for everyone. With a focus on equity, inclusion, and reducing healthcare disparities, we aim to remove barriers to good health and foster a diverse, innovative, and sustainable healthcare environment.