Medical Director (Inpatient) Missouri
: Job Details :

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. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization 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 Optum team in Missouri. 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 employers, 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 in the state of Missouri 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
• Responsible for collaborating with operational and business partners on clinical and quality initiatives at the site and customer level to address customer expectations
• 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
• Maintain proficiency in all required software and platforms