Optum
Network Medical Director - St. Louis, MO - Midwest RBE - Remote with Travel
Saint Louis, MO
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.
Primary Responsibilities:
- Leads onboarding discussions with new practices joining the network, focusing on setting appropriate and customized performance expectations in collaboration with the practice leaders
- Establishes and messages clear standards and expectations for the professional performance of the provider/provider groups in their designated market(s) of the Midwest RBE
- Collaborates in teaching clinicians and clinical operations teams 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
- Seeks to align Risk Adjustment, Quality, and Affordability initiatives internally and translate into ways network practices can actively engage in easily using these resources
- Operates with a tone of service and collaboration, leading their designated market(s) in a dyad partnership with the Client Services Directors and designated Account Managers
- Collaboratively works with the clinical and operational staff of the practices to develop strategies and design solutions to improve the value of care, clinical outcomes, affordability, and patient experience
- Works with RBE leaders to support integration of Quality Improvement programs, Utilization Management reports, and Disease Management programs
- Reviews and trends group/provider performance data to identify and strategize opportunities for improved performance
- Reports out at the Value Based Care Council, Quality Committee, Regional Executive committee, or Provider Meetings as requested
- Travel within their assigned state(s) on a regular basis as needed with occasional overnight travel
Required Qualifications:
- M.D, D.O., or M.B.B.S
- Board certification in Family or Internal Medicine
- Active unrestricted license to practice medicine in Missouri
- 5+ years of recent clinical practice experience after completing residency training
- Experience and knowledge of the local market
- Current unrestricted driver’s license
- Able to travel, with occasional overnight travel
Preferred Qualifications:
- 2+ years of experience in a physician leadership role in medical facility or related environment preferred Well-versed in guiding conversations with clinicians, operations teams, and executive leadership in various organizations
- Able to quickly customize the conversation with contracted groups at various stages of population health development.
- Proven track record of working well with Physicians, APRN, 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.
- Knowledge of managed care, including risk adjustment, affordability, quality, utilization management, care management, quality
- Advanced knowledge of Medicare Advantage and SNP/D-SNP programs
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Posted December 13, 2024