Medical Director - NV Command Center, Medical Management

Job ID: 97807557824Posted: 2026-08-01Location: Las Vegas, Nevada, United StatesSalary: $248,500 - $373,000/yearJob Area: Medical & Clinical OperationsCompany: UnitedHealth GroupFor those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.The SMA Medical Director provides leadership for the acute management processes ensuring appropriate decisions are made that are in alignment with performance metrics for the on the management of its patient populations . The Medical Director will also act as a liaison with the SMA Hospitalists and PCPs as well as the network Hospitalist groups by providing education regarding medical management processes and operating procedures including; Milliman guidelines, Observation process, medical management principles, grand rounds, coordinating the patient transition to post acute stytem and will work closely with SMA Primary care and specialist. Will intervene and engage in conflict resolution between the Hospitalists and PCPs. Will educate and interact with clinical and case management staff regarding utilization practices and effective resource management. Provide medical decisions for prior authorization as required for inpatient, post acute and outpatient requests.Position in this function manage the clinical review of long stay cases in acute setting with case management team and attending providers. Recommend services within the organization for discharge planning including assistance with home care, palliative, LTAC, SNF for bridges towards wellness. Shorten OBS cases with services to support discharge as well as prevention for readmission.Primary Responsibilities:Provide guidance and direction to physicians and nurses regarding all aspects of medical care and multi-levels transitions of careOversee TOC processes to ensure reduction in readmissionAnalyze data to identify trends and opportunities towards success measures of the command centerSupport overall regional and corporate goals to ensure continued growth, safety of the members and profitabilityParticipate in strategic development and implementation of best practices for the command centerEducate physicians and nurses on resources and intercede when company resources are not performing towards their operation expectationsEstablish relationships with employed and network hospitalist groups to promote the goals of the command centerParticipate and guide clinical care towards Optum protocolsReport, collaborate and implement plans as directed with the Sr. Medical DirectorYou'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:MD/DO Board Certified in a post graduate clinical specialtyMD/DO Licensed State of NV (or ability to obtain)5+ years related professional experience in managed care environment4+ years of related supervisory/management experiencePreferred Qualifications:Experience in Hospital settingKnowledge of Medicare coverage criteriaDemonstrated excellent medical management, leadership skills and excellent communication skillsProven good skills in making presentations and teachingProven solid organizational and prioritization skillsProven ability to make medical necessity decisions based on Medicare coverage criteriaProven to integrate guidelines/tools to negotiate most effective plan of careProven to formulate plans that incorporate the health plan benefits, community services, and patient self-directionWorking Conditions:Work in office and in acute hospital and/or sub-acute to develop relationships with the hospital attending physicians and hospital administrative staffDriving up to one hour per dayCompetencies for High Performers: Participation in departmental projects assigned by Sr. Medical DirectorMetric measures of success: Admission/K, Readmissions/K and Observation rate discharge, LOS Observation Rate. Observation rate of engagement with high-risk patients, improved readmission rate of high-risk patients (10 days) and engagement of PCP HFU ratePay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $248,500 - $373,000 annually based on full-time employment. We comply with all minimum wage laws as applicable."At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.