Medical Director – Post Acute Care (Remote)


As the Medical Director you will provide clinical oversight of the Utilization Management and transitional case management for our Post Acute Care program which includes Utilization of Post-Acute Care (PAC) facilities, medically appropriate steerage to home, coordination of discharges and post discharge follow up to prevent readmissions. A key part of the role is to work with strategically with UM leaders and market engagement director to overcome facility barriers to discharge. Clinical conversations with facility physicians as needed to impact admissions to PAC facilities and PAC length of stay. In this role the Medical Director will perform medical necessity reviews utilizing industry standard criteria, as well as client specific clinical criteria, for Skilled Nursing Facility (SNF), Long Term Acute Hospital (LTCH) and Acute Inpatient Rehabilitation Facility (IRF). The Regional Medical Director will also be responsible for support hospital discharge management for 90 days post discharge providing education and high risk member support to the Readmission Nurse Coach Program.

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