Medical Director - Specialty Management

Life Changing Work

Want to make a real difference in the lives you touch? LOOK NO FURTHER.

Optum is a physician-led, close-knit team that has been long-respected in Southern California. We are passionate about patients. We are leading the state of California toward better healthcare practices.

Primary Responsibilities:

• Provide medical and operational guidance at outpatient specialty clinics including, but not limited to, managing quality, clinical metrics in addition to practicing as a Specialist one day per week.
• Drive development and implementation of specialist guidelines to enable consistency and greater effectiveness across the employed and contracted specialist network to build a One Optum community.
• Provide medical leadership and physician advice to the quality management area with respect to quality improvement studies, quality improvement committees, and primary care assessments (both office-site assessments and medical record document reviews).
• Provide medical expertise for traditional utilization management services and resources for outpatient medical, surgical, and pharmacy activity.
• Educate and communicate with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization, and effective resource management.
• Participate and may facilitate conformance to DHCS, CMS, DMHC, NCQA and other regulatory requirements

Required Qualifications:

• Possess a current and unrestricted MD or DO license in California
• Board certification in your chosen specialty
• 5+ years of clinical practice experience
• 2+ years of experience working in a managed care setting
• Prior experience working with clinical information technology systems
• EMR Proficient
• Proven excellent communication and time management skills
• Comfortable presenting in group setting
• Willing to travel to clinic sites in region for physician engagement and meetings