The CareCentrix Post-Acute Care program is a comprehensive offering that manages financial risk for the costs of care for 90-days after a patient’s discharge from the hospital. The program identifies the recommended site-of-care for the patient, manages length of stay (LOS) if a Skilled Nursing Facility (SNF) is appropriate, and aims to reduce hospital readmissions. Our program also coordinates all of the services required for a patient to transition to their home faster and safer, by using home health, durable medical equipment and home infusion providers; all of whom are supported by our readmission reduction team.
This position provides clinical oversight of the Post-Acute Care (PAC) program for CCX, performing the full range of PAC medical necessity reviews utilizing Interqual as well as Client’s clinical criteria for Skilled Nursing Facility (SNF), Long Term Acute Hospital (LTACH)/Inpatient Rehabilitation Facility (IRF) as well as Home Health Service, DME and Home Infusion,
The PAC Medical Director provides consultative services to CareCentrix PAC staff as needed.
Must be an MD or DO with an active and unencumbered medical license in Connecticut. Additional licenses in other states may be required, depending on the CareCentrix client payer account rules, which may require multiple state licenses to be held concurrently. Minimum of 5 years’ experience in an area of relevant clinical practice, and prefer at least 3 years’ experience with supporting utilization management reviews, managed care programs or care delivery networks. Should have expertise in the Post-Acute Care field, including current knowledge on best practices, as well as a general knowledge of requirements of regulatory and accreditation standards for payers and health care providers. Must be able to travel to and participate in meetings at hospitals, rehabilitation facilities, clinics, and health plans, and other locations as needed
CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.