Medical Director, Utilization Management (Home Health, Acute & Post-Acute)
Clover Health
Location: Remote - USA, United States (Remote)
**Medical Director, Utilization Management (Home Health, Acute & Post-Acute)** **What you'll do** - Review authorization requests for Home Health, acute inpatient, post-acute, outpatient, and pharmacy services - Serve as primary physician reviewer for complex Home Health authorization requests - Perform peer-to-peer discussions with physicians and providers to facilitate appropriate care decisions - Mentor and educate Utilization Management nurses on complex Home Health cases **What they're looking for** - Medical expertise to determine medical necessity across service lines - Experience with CMS Home Health regulations and clinical guidelines - Ability to serve as physician escalation point for complex cases - Strong partnership skills with clinical teams and external providers **Details** - Location: Remote - USA - Type: Not specified - Salary: null
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