Medical Director, Inpatient Care Management - Missouri Job at Optum, Missouri

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  • Optum
  • Missouri

Job Description

We are currently seeking an Inpatient Care Management Medical Director to join our Optum team in Missouri (working remotely from their home office within the State.) 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.

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
  • 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

Required Qualifications:

  • MD or DO with an active, unrestricted medical license
  • Current Board Certification and maintenance in an ABMS or AOBMS specialty
  • 5+ years clinical practice experience
  • Private home office and access to high-speed Internet
  • Technical proficiency in computer software and systems

Job Tags

Local area, Remote job, Home office,

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