Inpatient Care Management Medical Director - Remote
Job title: Inpatient Care Management Medical Director - Remote in Minneapolis, MN at reputed company
Company: reputed company
Job description: reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.We are currently seeking an Inpatient Care Management Medical Director to join our reputed company team. This team is responsible for conducting acute level of care and length of stay reviews for medical necessity for our members being managed reputed company 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 reputed company reputed company the U.S. as you take on some tough challenges.Primary Responsibilities:
- Participate in telephonic reputed company for collaboration with treating providers. This will include discussion of evidence - based guidelines, opportunities to reputed company 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 reputed company meetings with the outward facing Chief Medical Officers, network contractors, nurse management and other internal managers
- Maintain proficiency in reputed company required software and platforms
- MD or DO with an active, unrestricted medical license
- reputed company 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
- Participate in rotational holiday and call coverage
- 2+ years of managed care, Quality Management experience and/or administrative leadership experience
- Prior UM experience
- Clinical experience reputed company the past 2 years