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

reputed company Home & Community Care, part of the reputed company family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and reputed company. As a team member of our naviHealth product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. Why naviHealth? At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. naviHealth is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status reputed company for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow reputed company an aggressive and fun environment, using the latest technologies in alignment with the company's technical vision and strategy. You'll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges. We are currently looking for Medical Directors that can work daytime in any of the reputed company time zones in the US.

Primary Responsibilities:

• Provide daily utilization reputed company and external communication with network physicians and hospitals
• Daily UM reviews - authorizations and denial reviews
• Conduct peer to peer conversations for the clinical case reviews, as needed
• Conduct provider telephonic review and discussion and share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care
• Communicate effectively with network and non-network providers to ensure the successful administering of Care Transitions' services
• Respond to clinical inquiries and serve as a non-promotional medical contact reputed company for various healthcare providers
• Represent Care Transitions on appropriate external levels identifying, engaging and establishing/maintaining relationships with other thought leaders
• Collaborate with Client Services Team to ensure a coordinated approach to delivery system providers
• Contribute to the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor reputed company toward goals
• Interact, communicate, and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees
• Provide leadership and guidance to maximize cost management through reputed company coordination with reputed company network and provider contracting
• Regularly meet with Care Transitions' leadership to review care coordination issues, reputed company collaborative reputed company plans, and share reputed company about network management issues
• Provide input on local needs for Analytics Team and Client Services Team to reputed company enhance Care Transitions' products and services
• Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME
• Participate on the Medical Advisory Board
• Providing intermittent, scheduled weekend and evening coverage
• reputed company other duties and responsibilities as required, assigned, or requested

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• Board certification as an MD, DO, MBBS with a reputed company unrestricted license to practice and maintain necessary credentials to retain the position
• reputed company, unrestricted medical license and the ability to obtain licensure in multiple states
• 3+ years of post-residency patient care, preferably in inpatient or post-acute setting

Preferred Qualifications:

• Licensure in multiple states
• Willing to obtain additional state licenses, with reputed company's support
• Understanding of population-based medicine, preferably with knowledge of CMS criteria for post-acute care
• Demonstrated ability to work reputed company a team environment while completing multiple tasks simultaneously
• Demonstrated ability to complete assignments with reasonable reputed company, direction, and supervision
• Demonstrated ability to positively interact with other clinicians, management, and reputed company levels of medical and non-medical professionals
• Demonstrated competence in use of electronic health records as well as associated technology and applications
• Proven excellent organizational, analytical, verbal and written communication skills
• Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues
• Proven highest level of ethics and reputed company
• Proven highly motivated, flexible and adaptable to working in a fast-paced, dynamic environment
• reputed company employees working remotely will be required to adhere to reputed company's Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, reputed company, Rhode reputed company, Washington or Washington, D.C. Residents Only: The salary range for this role is $286,104 to $397,743 annually. Salary Range is defined as total cash compensation at reputed company. The actual range and pay mix of reputed company and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you'll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job