As the Medical Director - Post Acute Care you will provide clinical oversight for one or more CareCentrix markets including Utilization Management reviews of Post-Acute Care (PAC) stay requests, 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 strategically with UM leaders and market engagement directors to overcome facility barriers to discharge. Peer-to-Peer conversations with hospital physicians either pre or post denials, as needed to impact admissions to PAC facilities. Clinical rounds with nurse teams to support PAC length of stay and be available to speak to Appeals in client meetings. In this role, the Medical Director will perform medical necessity reviews utilizing industry standard criteria such as Interqual or MCG and CMS. The primary work will involve PAC facility management including: Skilled Nursing Facility (SNF), Inpatient Rehabilitation Facility (IRF) and Long Term Acute Care Hospital (LTCH). The Medical Director may also be responsible to develop trainings and quality improvement interventions to support optimal PAC outcomes including readmission prevention program for 90 days post discharge.
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CareCentrix maintains a drug-free workplace.
We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.
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