Medical Director - Telecommute in Northern California, East Bay Area
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
Looking for a chance to drive measurable and meaningful improvement in the delivery of value-based care/population health? This is an exciting opportunity to build the future of health care as the medical advisor on a team dedicated to an innovative collaboration between Optum and a strategic provider partner in Northern California. Be part of changing the way health care is delivered while working with a Fortune 5 industry leader.
The successful candidate must be passionate about driving improvements in health care, effective at working in a fast-paced environment and tenacious when working in complex environments as well as confident and collaborative in their interactions with senior executives, physicians and business partners.
If you are located in Northern California, East Bay Area, you will have the flexibility to telecommute* as you take on some tough challenges.
- Serve as a Medical Advisor to clinical teams working to advance value-based care/population health capabilities to ensure the right service is provided at the right time for each delegated member
- Provide clinical advisory support for Utilization Management and Ambulatory Care Management Services for delegated Medicare and Commercial HMO populations at the client site
- Work collaboratively with operations and client site leadership to review business metrics, trend reports, utilization metrics, site performance metrics, and present analysis and recommend actions
- Work collaboratively with operational and client site leadership to establish goals, prioritize projects, and develop strategy for advancing value-based care at the client site
- Work collaboratively with operations and client site leadership to support initiatives that enhance the quality of services, achieve mutually defined improvement goals, and promote evidence-based medical care
- Serve on project/improvement teams as a leader, participant, and/or consultant; Collaborate with internal business partners to promote value levers and other strategic initiatives
- Support ambulatory care management team to achieve optimal clinical outcomes for high-risk populations
- Based on risk criteria, conduct clinical reviews for patients enrolled in care management
- Participate in interdisciplinary care management conferences, case reviews and huddles to advise on appropriate care delivery
- Participate in complex case conferences with Health Plans and assist client site leadership with ongoing Health Plan performance improvement
- Partner with inpatient team to facilitate patient handoffs and transitions
- In conjunction with Clinical Managers, work to improve the nurse knowledge base and management of cases through site leadership meetings, clinical teaching sessions, team meetings, case audits, nurse tools, and one-on-one case discussions
- Be involved in telephonic outreach for collaboration with treating providers. This will include discussion of evidence-based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expenses
- Participate in client, Health Plan and consultant presentations and respond to questions related to clinical performance and utilization
- Advise on questions and issues related to utilization and medical expense reduction efforts for clients, operations and consultants
- Act as a consultant to the operational and product leaders on clinical issues related to the business model, value levers, and strategy / product / program development
- Partner with client site Population Health Medical Director on; payor case-based reviews, medical provider development, repatriation issues, operational issues that impact utilization and total cost of care
- Partner with client site leadership on; client relationship management, strategy implementation, on-going performance improvement, and presenting performance at leadership team meetings
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.
- MD or DO degree
- Active, unrestricted physician state license – CA
- 5+ years of clinical practice experience post residency
- Proven understanding of Utilization Management and Ambulatory Care Management operational functions
- Proven understanding of and concurrence with evidence-based medicine (EBM) and managed care principles
- Primary residence must be located in Northern California, and able to commute to the East Bay to work onsite in the office up to 3 days per week
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
- Board certification in primary care specialty
- Hands-on utilization and/or quality management experience
- Substantial experience in using electronic clinical systems
- Experience with influencing, motivating and working in a highly matrixed team
- Excellent presentation skills for both clinical and non-clinical audiences
- Proven operational focus with demonstrated project management, clinical process improvement, change management and execution skills
- Success in using data to identify opportunities and changes, creating action steps and delivering results based upon findings
- Proven belief in EBM (Evidence Based Medicine) and value-based care, familiarity with current medical issues and practices
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.