Part Time - Inpatient Care Management Medical Director - Remote

Job Overview

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.

About the Role

We are currently seeking a Part-Time 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.

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
• Responsible to 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
• Must be able to work a minimum of 20 hours per week; to include weekend hours
• Maintain proficiency in all required software and platforms

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