Optum Serve Medical Director - VA Community Care Network - Remote in US

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.

Optum Serve is part of the family of companies that make UnitedHealth Group, one of the leaders across the US healthcare system. Optum Community Care Services (CCS) sits within Optum Serve supporting federal contracts such as the Veterans Administration Community Care Network (VA CCN) which provides a network of community care providers to serve Veterans.

The Optum Community Care Services (CCS) Medical Director works diligently to oversee clinical quality provided from community care providers to Veterans. The medical director will work collaboratively with the Patient Safety Specialists in reviewing medical records and determining applicable standards of care. The medical director will Chair the Med/Surg Peer Review Committee and oversee that the Peer Review Committee meets all applicable regulations and legal requirements. The medical director will facilitate and/or attend other committees including the Clinical Quality Improvement Program Committee.

The Medical Director will be accountable for ensuring that initiatives focused on clinical excellence and CCS clinical quality program requirements are implemented and successfully managed to achieve performance expectations and meet all contractual requirements. The medial director will perform clinical quality reviews of medical/surgical care, program integrity reviews involving regulatory compliance, health care delivery, and other functions to ensure that the best quality of care is provided to Veterans who are community care beneficiaries. This position requires working collaboratively and closely with internal and external partners. The medical director is expected to always communicate effectively and professionally with internal and external partners including the clients. Utilization management on such tasks as concurrent review and prior authorization review may be required in future contracts.

This position reports to the Chief Medical Officer, Community Care Services.

Required Qualifications:

• MD or DO with an active, unrestricted license
• Current board certification in Internal Medicine or Family Medicine, Surgery, Physiatry or Emergency Medicine
• 5+ years clinical practice experience
• Demonstrated familiarity with current medical issues and practices
• Proficient understanding of Evidence Based Medicine and the application with care and decision making
• Proven ability to develop relationships with network and community providers and VA providers
• Demonstrated superb communications skills
• Demonstrated excellent time management skills
• Proven data analysis and interpretation skills
• Proven ability to focus on key metrics
• Demonstrated creative problem-solving skills
• Demonstrated ability to focus on priorities
• Demonstrated ability to timely and accurately complete time entries within Costpoint and Global Self Service per company policy
• Demonstrated ability to comply with all UHG and Optum employee policies
• Ability to travel less than 10%

Preferred Qualifications:

• 5+ years of experience in clinical quality
• Experience with Veterans and/or Military medical management

About Optum

Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare. We’re a global organization that’s evolving health care so everyone can have the opportunity to live their healthiest life. With our hands across all aspects of health, we'll provide you with a rewarding career that enables you to grow in the directions that best fit your passions. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together.