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In support of the Midwest Region RBE mission, vision, and strategic goals to achieve the quadruple aim by focusing on value-based care, the Senior Medical Director provides medical leadership in the adoption of the key principles, tools, technologies, and clinical support services essential to population health in a service setting. Through this work, the Senior Medical Director helps create an environment that encourages physicians, care providers and support personnel to collaborate in building successful practices that produce quality medical care in a cost-effective manner while enhancing patient quality of life. This position works actively on the formation of guidelines, policies, practices, procedures, and recommendations for appropriate clinical and business actions. In addition, this role is accountable for supporting our clinical services team in managing care management needs for individual patients.
The Senior Medical Director works collaboratively across the team. This key leadership role works collaboratively with the senior leadership team to design and implement effective practice educational and engagement strategies designed to create meaningful change in the delivery of care for all the practices we support. This will include engaging practices in a side-by-side, face-to-face fashion with other members of the team of professionals in support of performance improvement activities guided by a variety of performance data and benchmarks.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Medical Leadership and Network Engagement
Provides medical leadership for the practices supported by the Midwest RBE, optimizing education and messaging to the practices we support regarding care management, quality, risk adjustment, clinical education, affordability, and overall performance Provides direct education to medical and clinical leadership in the practices we support to help them become successful in value-based care, helping practicing clinicians understand and learn about the value-based care clinical and operational model As needed, participates in team and committee quality and policy meetings, quality improvement projects, quality of care reviews, and process improvement activities Collaboratively work with the clinical and operational staff to develop strategies and design solutions to improve the value of care, clinical outcomes, affordability, and patient experience for individuals with a high level of needs Accountable for relationship management, supporting the Joint Operating Committee Meetings for all major groups we are contracted with, to ensure these meetings are productive and meaningful in driving performance and insights Participates in and provides leadership at regional, community and other organizational meetings. Represents Midwest Region RBE at internal national clinical forums and workgroups Reviews and trends provider performance data to identify and strategize opportunities for provider improvement Works directly and in close cooperation with participating/contracted hospitals, allied health plans, allied health professionals and providers in executing the Midwest Region RBE administrative responsibilities in the management and care of managed care subscribers/enrollees Supports the team in discussions with potential new network partners to ensure values congruence and alignment on striving toward the quadruple aim Collaboratively works with the broader RBE team to engage the network and employed clinicians with in-person visits
Quality Program
Works with leadership in planning and implementation of innovative clinical care models. Supports and advocates for the development of OptimalCare solutions, identifying opportunities to bring deeper clinical collaboration to the practices we service Actively uses and supports quality improvement principles and methods in an effort to improve inter- and intra-departmental processes; participates on quality improvement project teams as a member, leader and/or sponsor
Knowledge, Skills and Abilities:
Fully embraces the transition to value-based care for practices of all sizes. Has direct experience with that transition in their own clinical practice Able to serve as an ambassador for OCN among providers, including hospital systems, public hospital districts, large/medium/small multi-specialty and single specialty practices, facilities, and ancillary services Able to work collaboratively with a wide variety of health care professionals and staffs, both inside and outside of the organization Knowledge of managed care, including quality, risk adjustment, affordability, utilization management, care management, credentialing, and peer review Advanced knowledge of Medicare plan design Knowledge of healthcare administration, policies, and operating procedures Skill in working cooperatively with patients, physicians, and staff to articulate complex concepts, including managed care principles, in readily understandable terms Ability to analyze complex problems and formulate plans, solutions, and course of actions Ability to establish and maintain cooperative working relationships with individuals at all levels of the organization Ability to analyze and interpret complex data Ability to research and inform comprehensive reports Knowledge of specific communication needs with the ability to listen actively and respond in a timely, competent manner both verbally and in writing Demonstrated skill in learning and utilizing information technology systems
You'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:
Current unrestricted Physician (MD/DO) license Current board certification in ABMS or AOA recognized medical specialty 5+ years of recent experience in clinical practice 5+ years of experience in leadership role in medical facility or related environment Significant experience in Medicare Advantage and Population Health approaches Proficient with MS Office (MS Word, Email, Excel, Power Point, One Note, Teams) Ability to travel up to 25% to clinical sites across Midwest Region (Indiana, Ohio, Michigan, Illinois, Kansas, Missouri, North Dakota, South Dakota, and Nebraska)
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington residents is $363,459 to $ 574,956 per year. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.
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.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment