Clinical Medical Director

2 days ago

Peralta, United States Optum Full time

The Clinical Medical Director, is a member of the leadership team and responsible for the quality, cost and service levels of health care provided by Optum New Mexico. This position works closely with the senior leaders to direct, manage and evaluate all clinical operations. This position is also responsible for planning, implementing and monitoring of activities in direct support of patient satisfaction, quality improvement.
LEADERSHIP COMPETENCIES:

Business Acumen: Uses economic, financial, market, and industry data to understand and improve business results; uses one’s understanding of major business functions, industry trends, and own organization’s position to contribute to effective business strategies and tactics.
Leadership: Demonstrates the traits, inclinations, and dispositions that characterize successful leaders; exhibits behavior styles that meet the demands of the leader role. Identifies goals for site or department in consultation with other Medical Directors and Operations leadership; leads efforts by providers and teammates to achieve those goals
Building Trust: Interacts with others in a way that gives them confidence in one’s intentions and those of the organization.
Facilitating Change: Encourages others to seek opportunities for different and innovative approaches to addressing problems and opportunities; facilitates the implementation and acceptance of change within the workplace. Encourages others to participate in creating a positive culture of the Clinic and the Medical Group and to uphold the Mission, Vision and live the Core Values.
Managing Conflict: Deals effectively with others in an antagonistic situation; uses appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
Building Strategic Work Relationships: Develops and uses collaborative relationships
to facilitate the accomplishment of work goals.

ESSENTIAL FUNCTIONS:

Provide leadership and communication for physician leaders, physicians and clinical staff.
Partner with medical management staff to promote clinical process improvement and access enhancement.
Lead population health initiatives to align with the greater mission of the organization.
Responsible for patient engagement and responsible for implementing or sustaining improvement. plans around survey information on such topics as NPS, HOS/CHAPS, and other measures.
Support patient growth initiatives.
Ensure effective quality assurance and risk management processes.
Ensure customer satisfaction and compliance with regulatory standards.
Manage cost effective delivery of health care within the clinical practice management operations.
Oversee that all NCQA and other accreditation standards are met.
Complete ongoing professional medical management development programs.
Responsible for effective interviewing, selection, orientation, development and retention of providers.
Support strong partnership with the mergers and acquisitions (M&A) team in alignment with growth initiatives.
Establish direct professional relationship with key departments including the risk bearing entity (RBE), pharmacy, underwriting, medical adjudication, claims and provider relations, and assist with issues and/or concerns.
Required Qualifications:

Fully licensed as a physician in the state of New Mexico.
Current MD/DO medical license in the state of New Mexico Board Certified or in the process of obtaining certification unless granted an exemption by Credentialing Committee.
New Mexico Pharmacy/DEA Registration if applicable to practice. Current BLS Certification
Minimum 3 - 5 years’ experience at senior leadership level in medical group or network; Minimum 5 - 7 years’ experience as a practicing physician preferably in a medical group.
Experience in medical utilization management, medical quality assurance, quality improvement techniques, risk management and a value-based care environment.
Extensive knowledge of clinical operations; strong knowledge of management practices, human relations, consensus building and collaborative ability
Excellent communication skills, both verbal and written.
Ability to comfortably use Microsoft Word, Excel, and PowerPoint.
Thorough understanding of medical group business models and clinical processes.
Excellent understanding of medical group financial concepts, including revenue cycle, physician compensation models, and preferably including managed care financial concepts (capitation, IBNR, MLR)

Preferred Qualifications:

Master's Degree in related field

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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