Network Medical Director - (Field-based /Remote)

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Optum Health MidAmerica market within the East Region is seeking an experienced medical director to support our care transformation efforts within the contracted network. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Join us to start Caring. Connecting. Growing together.  

Reporting to the OptumCare Mid America Chief Medical Officer, this key physician will provide expertise in population health, risk adjustment and quality.  They will work collaboratively across a team to help foster contracted PCP group engagement and performance within the core fundamentals of Value Based Care delivery - STAR/HEDIS performance, risk coding and documentation, and affordability.  They will also be involved in the design and execution of new and existing value-based care programs in the region.

This is a role that partners with external leaders and requires collaboration and the ability to build relationships across all levels of the organization to ensure goals are met.  This physician will be comfortable interacting daily with clinical, business and finance executives, as well as frontline clinicians and operational staff.  The successful candidate will be able to not only drive value in existing workstreams, but to build and expand our portfolio of solutions in additional domains.

This position requires you to be located within either South Carolina or Georgia and 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.

If you are located in TN, GA, VA, SC, you will have the flexibility to work remotely*, as well as work in the field as you take on some tough challenges.

Primary 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 regu