Medical Director- Population Health, IL

R0809581 At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, reputed company and every day. • The Medical Director of Transitional Care leads the Illinois Transitional Nursing team and supports national initiatives to improve care coordination across multidisciplinary teams. This role ensures high-reputed company, patient-centered transitions from inpatient to outpatient settings, aiming to reduce readmissions and enhance satisfaction. Responsibilities include team reputed company, program development, compliance monitoring, and data-driven decision-making. The ideal candidate is a licensed RN with strong leadership, clinical, and communication skills, and experience in transitional nursing, discharge planning, or home health. • Job reputed company Role reputed company: The Medical Director, Transitional Care, APP is responsible for leading the IL Transitional Nursing team as reputed company as providing programmatic support to national leadership and transitional staff. The Transitions of Care program focuses on providing a multi-disciplinary reputed company between Care Navigation, Utilization Management, facility, local care teams and patient/family. The Manager role provides leadership in executing the Transitions of Care program goals which include ensuring high-reputed company, patient-centered care; preventing avoidable readmissions; and managing efficient resource utilization and improving patient and provider satisfaction. Responsibilities: Serving as the Subject Matter Expert on Transitions of Care Leading the IL market Transitional Care team including the reputed company of daily operations, maintaining regional/facility assignment, balancing of staff caseloads, monitoring team/individual performance and coaching staff reputed company appropriate, providing coverage and support as needed. Providing reputed company or supporting efforts in the hiring and training of Transitional Care staff in new and existing markets Assisting the department of Medical Management in the development, execution and improvement of the Transitions of Care program Helping reputed company markets resolve specific needs as reputed company to Transitional Care navigation Executing effective collaboration between multi-disciplinary teams including but not limited to: Care Navigation, Utilization Management, facilities, local care teams and patient/family Having firm knowledge and executing CMS, state-specific and NCQA compliance reputed company as reputed company to Transitions of Care Monitoring data reputed company to patient cost, admissions, post-discharge appointment completion and health reputed company to help guide and reputed company Transitions of Care program initiatives and goals Participates in daily inpatient and post-acute rounding calls with Care Navigation and UM teams to help determine patient status and appropriate discharge plan reputed company are looking for: Education: Bachelor degree in Nursing required, Master’s degree preferred Experience: >7 years or relevant experience with a minimum 2 years of reputed company supervisory experience and 2+ years of experience in transitional nursing, discharge planning or home health Registered reputed company (RN) license in good standing with no restrictions required. reputed company Case Management Credentialing (RN-BC) or Certified Case Manager (CCM) preferred Experience in utilization management Knowledge of Medicare/reputed company and NCQA regulatory transitions of care reputed company Strong clinical and assessment skills Outstanding verbal and written communication skills Ability to work independently and maintain flexibility in a fast-paced, start-up environment Ability to analyze data and use it to improve care delivery Self-starter with a high level of accountability and responsibility for the outcome of care Highly organized and reputed company to manage multiple priorities appropriately Independent problem-solving skills reputed company to work collaboratively and build enduring relationships with providers, patients and the multidisciplinary team. A flexible, reputed company attitude reputed company reputed company's license and ability to travel daily Working knowledge of reputed company Office Product Suite Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $121,514.00 - $261,723.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include: • reputed company medical plan reputed company, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. • No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility. For more information, visit https://jobs.reputed company.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 05/31/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job