Medical Director – Utilization Management

🔥 2 hours ago

🌪️ Kansas – Remote

🌪️ Kansas – Remote

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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WellSky

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1980

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 Private Equity Round on 2020-07

Healthcare • Consulting • Logistics

WellSky is a leading healthcare technology company dedicated to improving healthcare and community care outcomes worldwide. By offering comprehensive software solutions and analytics, WellSky enables healthcare providers, payers, and community organizations to collaborate and enhance care quality and accessibility. Their focus spans intelligent care management, connected care networks, and transformative analytics, aiming to create more efficient, inclusive, and sustainable healthcare systems. WellSky addresses social determinants of health and emphasizes patient and family engagement, supporting care in various settings including home, long-term, and acute care.

📋 Description

• Provide oversight, medical guidance, and support to WellSky’s clinical management acute, emergency department, and post-acute care solutions and programs • Provide expertise and leadership in medical management and care coordination for acute and post-acute care services • Lead improvements of post-acute clinical programs through strategy, design, and implementation • Provide timely expert medical review for acute ED and post-acute care services, including SNF, IRF, LTACH, and HH • Provide clinical opinions about medical services under review, including post-decision reviews • Be available for escalations from nurse teams • Document clinical review findings, actions, and outcomes according to policy and regulatory and accreditation requirements • Provide guidance for clinical operational aspects of ED, acute, and post-acute care programs • Collaborate with acute ED providers to coordinate and/or support care transitions • Identify and develop innovation opportunities to increase effectiveness and quality • Develop education and training and resolve issues • Participate in client JOCs or partner/stakeholder meetings as needed • Perform other assigned duties

🎯 Requirements

• Doctoral degree in a relevant medical field • At least 6-8 years of relevant work experience • Active, unrestricted medical license (MD or DO) • Board certification in a relevant specialty, preferably in Physical Medicine and Rehabilitation, Internal Medicine, Emergency Medicine, or General Surgery • Willing to travel up to 10% based on business needs • Willing to work additional or irregular hours as needed • Must work in accordance with applicable security policies and procedures to safeguard company and client information • Must be able to sit and view a computer screen for extended periods of time • Applicants for U.S.-based positions must be legally authorized to work in the United States • Verification of employment eligibility required at the time of hire • Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates

🏖️ Benefits

• Excellent medical with Rx, dental, and vision benefits • Mental Health support through EAP • Generous paid time off • 13 paid holidays • 100% vested 401(K) retirement plans • Educational assistance up to $2500 per year

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