Medical Director - Specialty Management

Irvine, CA

Inpatient and outpatient

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

Posted May 12, 2022