Embrace Value-Based Care as a Network Performance Medical Director

Albuquerque, NM

Key Info


Non clinical

Network Performance Medical Director – Optum New Mexico

Position Highlights:

  • Strategic leadership over the Independent Practice Affiliate Program in New Mexico
  • Working on best practices, policies, telehealth and novel approaches for risk adjustment programs
  • Apply understanding of patient care quality metrics to enhance clinical outcomes (e.g., HEDIS; 5 STAR; disease-based metrics) in order to drive/achieve quality outcomes for Optum NM’s Affiliate Program
  • Lead efforts for RAF/HEDIS/STARS education to improve metrics and outcomes for the Affiliate Program
  • Effectively engaging and bringing understanding to our external constituents such as physicians, medical and specialty societies, hospitals and hospital associations, and state regulators
  • Identifying affordability opportunities through participation in local medical expense committees or market reviews
  • Provide assistance in appeals review where appropriate
  • Supporting all clinical quality initiatives and peer review processes


  • Top 10 ranking for America’s Best Cities for Foodies, Travel + Leisure
  • Top Big Best Cities for Active Families by Outdoor Magazine.
  • Top City with the Cleanest Air in America, Thrillist
  • Ranked Top 5 for “Secretly Cool Cities, Huffington Post
  • www.visitalbuquerque.org

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. Optum brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)

Posted July 24, 2020


Not Covered