Senior Medical Director, LA South
The Senior Medical Director is accountable for clinical & administrative leadership to clinicians within their region, quality excellence, and performance within the region. Along with leading the transformation of centralizing and integrating Legacy AppleCare, Legacy HCP and both IPA and clinic operations, this key leader also interacts with Physicians and APCs, operational leaders and IPA staff to ensure that patient needs are met in an efficient and medically appropriate manner. The Senior Medical Director is responsible for the Medical Management functions that include contracted partner and hospital relations, Utilization Management and business development. Collaborates with Physicians and other providers to improve the quality and efficiency of care in the network and integrate these providers into clinical initiatives.
The duties listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment.
- Working with the operational Dyad Partner, sets the strategic vision and performance goals for the region.
- Sets and implements clear standards and expectations for the professional performance of the providers to achieve:
- Excellence in patient satisfaction scores, including enhancing patient experience and services provided.
- Excellence in quality of care, including achieving medicine the highest scoring for P4P and Star Measures, and practicing evidence based.
- Excellence in cost effective care, inclusive of improving efficiencies and reducing expenses involving resource use.
- Works with the physician community around issues of patients, balancing business and clinical concerns.
- Willingness to travel throughout California regularly as needed
- Lead onboarding discussions with new practices joining the network (setting appropriate and customized performance expectations in collaboration with the practice)
- Collaborate with the practice engagement project manager, director of engagement, executive medical director, and leaders to prioritize initiatives and identify the appropriate implementation plan for network participants.
- Assists in teaching clinicians and management team about Medicare Risk Adjustment, Star ratings, and overall population health approach to patient care.
- Assists in coordinating efforts between network partners who are part of different organizations (primary care sites, and various specialties who are each in different organizations).
- Assists in the roll out of Optum Care clinical guidelines where appropriate at the direction of the quality committee.
- Collaborate with employed medical groups and network medical groups in a positive way while identifying opportunities for alignment of regional activities (ie. Care management/affordability initiatives, quality initiatives, new care models).
- Provide secondary assistance in supporting the contracting team and discussing with provider groups the value proposition for joining the network.
- Works with Optum CA Medical Directors for Quality, UM, Population Health, Practice Health and Safety to support the integration of Quality Improvement programs, Daily utilization Management reports, and Disease Management programs.
- Support patient safety initiatives.
- Support patient experience initiatives, including patient satisfaction and access.
- Supports ongoing improvements to the Primary Care Model of care with an emphasis on sustainability, comprehensive primary care delivery, quality performance, and patient experience.
- Collaborate with regional leaders on Care Coordination to understand and support reductions in the cost of care through appropriate institutional utilization and resource management by the service line.
- Assures that utilization of hospital care is appropriate and consistent with well-managed national and regional benchmarks.
- Assist in planning and implementation of lower cost alternatives to institutional care where appropriate
- Assure utilization of advanced imaging and prescribing is consistent with national and regional benchmarks.
- Help lead the primary care departments to focus on access and reduce inappropriate ER utilization.
- Graduate from an accredited medical residency program
- Master’s Degree in Business Administration, Hospital Administration or equivalent preferred
- Current unrestricted Physician (MD/DO) license for the State of California
- Current driver’s license
- 5 years of recent experience in clinical practice
- 5 years minimum experience in a physician leadership role in a medical facility or related environment
- 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
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.
At OptumCare, we’ve found that putting clinicians at the center of care is the best way to improve lives. Our physician-led organization is one of the most dynamic and progressive health care organizations in the world, serving over 17 million people through more than 45,000 aligned physicians and 9,000 advanced practice clinicians. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Learn more at www.workatoptum.com.
Would you thrive with OptumCare?
Do you practice evidence-based medicine?
Are you seeking a practice focused on patient-centered quality care, not volume?
Are you a team player - comfortable delegating and empowering teams?
Are you constantly seeking better ways to do things?
Do you want to be part of something better?
California Residents Only: The salary range for California residents is $363,459 to $574,956. 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.
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.