- Sets and implements clear standards and expectations for the professional performance of the providers in the OCN.
- Willingness to travel within Washington State on a regular basis as needed with occasional overnight travel.
- Lead onboarding discussions with new practices joining the network (setting appropriate and customized performance expectations in collaboration with the practice)
- Assists in teaching clinicians and management team about Medicare Risk Adjustment, Star ratings, and overall population health approach to patient care in both formal presentations and off the cuff at impromptu opportunities.
- Align work of Risk Adjustment, Quality, and affordability initiatives internally and translate into ways network practices can actively engage in easily using these resources.
- Set a tone of service and collaboration, leading the respective Pod in dyad partnership with the Regional Manager and the designated Practice Engagement Managers.
- Represent the voice of network practices on committees.
- Report to the Quality Committee, Regional Executive committee, or Provider Meetings as requested.
- Works with the Medical Director for Quality and Safety to support integration of Quality Improvement programs, Daily utilization Management reports, and Disease Management programs.
- 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 cost of care through appropriate institutional utilization and resource management by the service line.
- Assist in planning and implementation of lower cost alternatives to institutional care where appropriate.
- Help lead the primary care practices to focus on access and reduced inappropriate ER utilization.
- Be flexible and able to quickly customize the conversation with contracted groups at various stages of population health development.
- Well-versed in guiding conversations with clinicians, operations teams, and executive leadership in various organizations.
- Proven track record of working well with Physicians, ARNP, Physician Assistants, Coders, Schedulers, Managers, Directors, and Executives to assure care delivery is patient centered, timely, effective and evidence-based approach to clinical care across all Primary Care and specialty care participants.
- Serves as an ambassador for OCN among network providers.
- Knowledge of managed care, including utilization, care management, quality, credentialing, and peer review
- Advanced knowledge of Medicare and Medicaid plan design and coverage criteria
- Graduate from accredited medical residency program and be board certified
- Current unrestricted Physician (MD/DO) license for the State of Washington or the ability to obtain prior to start.
- 5 years of recent experience in clinical practice
- At least 5 years of experience in a physician leadership role in medical facility or related environment preferred.
- Current driver's license
- Must be willing to travel, with occasional overnight travel.
- Master's Degree in Business Administration, Hospital Administration or equivalent preferred.
- Board Certification and/or clinical practice experience in adult primary care (Family Medicine or Internal Medicine)
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Network Medical Director - Seattle, United States - UnitedHealth Group
Description
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)
Are you an inspirational leader who is passionate about value-based care? In support of Optum Care Network's (OCN) mission, vision, and strategic goals as an emerging Clinically Integrated Network, the Network Medical Director is the accountable leader for performance in population health programs within their designated pod or region. This opportunity provides direction, coordination, support, and accountability throughout the OCN, including Primary care practices of various sizes, multispecialty groups, hospitals, and ancillary facilities.
The Network Medical Director reports to the Senior Network Medical Director. This administrative role supports the Network Management Executive Leadership Team regarding all elements of performance throughout the network, including adherence to quality performance, timely access for patients, appropriate and accurate documentation and coding, patient engagement, practice engagement with central supports like care management programs provided by OCN, analytic platforms, wrap around care services.
This position requires you to be located within the state of Washington. Travel will be required within the state.
Medical Leadership
Knowledge, Skills, and Abilities
Required Qualifications:
Preferred Qualifications:
Washington Residents Only: The salary range for this role is $, to $, per year.Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and k 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: UnitedHealth Group 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.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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