Network Medical Director - (Field-based /Remote)

UnitedHealth Group•Nashville, TN

6d•$248,500 - $373,000•Hybrid

About The Position

The Optum Health MidAmerica market within the East Region is seeking an experienced medical director to support care transformation efforts within the contracted network. This role will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need. The position offers a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. The role involves providing expertise in population health, risk adjustment, and quality, working collaboratively to foster contracted PCP group engagement and performance in Value Based Care delivery, including STAR/HEDIS performance, risk coding and documentation, and affordability. It also includes involvement in the design and execution of new and existing value-based care programs. This role partners with external leaders, requiring collaboration and relationship-building across all organizational levels. The physician will be comfortable interacting with clinical, business, and finance executives, as well as frontline clinicians and operational staff, with the ability to drive value in existing workstreams and expand the portfolio of solutions. The position requires the candidate to be located within South Carolina or Georgia and be willing to travel across state lines to visit practice locations. It is a field-based position requiring frequent face-to-face meetings with local network medical practices. For those located in TN, GA, VA, SC, there is flexibility to work remotely, as well as work in the field.

Requirements

M.D. or D.O. degree
Current unrestricted license to practice medicine
Board certified in Internal Medicine, Family Medicine, or Critical Care
5+ years of clinical experience
Proven solid presentation and persuasion skills; ability to speak clearly and lead discussions with senior executives and large groups
Demonstrated ability to influence without authority
Willing or ability to travel, with occasional overnight travel
Demonstrated ability to implement complex programs and monitor implementation and necessary modifications

Nice To Haves

2+ years of experience in a physician leadership role in medical facility or related environment
General knowledge of clinical programs, trends and medical management, medical care delivery systems, utilization management, disease management, analytics quality management, contracting, provider relations and customer service
Understanding of healthcare finance and has worked in data intensive and metrics driven environment
Proven track record of working well with Physicians, APRN, Physician Assistants, Coders, Schedulers, Managers, Directors, and Executives
Proven ability to quickly customize the conversation with contracted groups at various stages of population health development

Responsibilities

Partnership with market clinical leaders
Builds/maintains/manages market stakeholder relationships across multiple layers and functions
Lead and support physician-to-physician discussions and problem-solving with medical group leaders, hospitalists, specialists, market CMO’s, and clinical leaders from market vendors and service providers
Assist analytical efforts to identify and quantify new opportunities to improve the value of services delivered to reduce low-value utilization while also improving quality, patient and provider experience
Proactively work with team to synthesize and communicate findings and bring together multiple stakeholders to deploy programs
Collaborates in teaching clinicians and clinical operations teams about Medicare Risk Adjustment, CMS STARs/HEDIS, and overall population health approach to patient care in both formal presentations and off the cuff at impromptu opportunities
Clinical support for operational teams
Establish and maintain evidence-based standards for clinical documentation and care coordination activities
Navigate professional body guidelines, published literature, coding rules and regulations to provide thought leadership and recommended actions to physicians
Emotional maturity for effective change management
Establish solid and lasting, trust-based relationships within team and external partners
Take initiative and self-start attitude to approach problems with energy and passion
Utilize a solid fact base to influence and lead physicians and support staff to implement change programs
Ensures overall program success
Reducing barriers for and working collaboratively with program implementation teams, including anticipating and responding to potential roadblocks
Conducts deep dive program reviews with relevant internal and/or external stakeholders to identify opportunities for continuous improvement
Interacts with senior management by providing thoughtful analysis on key decision points to drive initiatives forward
Demonstrates understanding of budgeting and forecasting tools, terminology, and processes
Travel within their assigned state(s) on a regular basis as needed with occasional overnight travel