Clinical Medical Director
3 days ago
The Clinical Medical Director plays a pivotal role in the leadership team at Optum New Mexico, overseeing the quality, cost, and service levels of healthcare provided. This position works closely with senior leaders to direct, manage, and evaluate all clinical operations, ensuring alignment with the organization's mission and vision.
Key Responsibilities:- 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 implementing or sustaining improvement plans around survey information.
- Ensure effective quality assurance and risk management processes.
- Manage cost-effective delivery of healthcare within 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 relationships with key departments, including the risk-bearing entity, pharmacy, underwriting, medical adjudication, claims, and provider relations.
- Fully licensed as a physician in the state of New Mexico.
- Board Certified in Internal Medicine/Family Medicine, 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 of experience at a senior leadership level in a medical group or network.
- Minimum 5-7 years of 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).
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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Clinical Medical Director
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Albuquerque, United States Optum Full timeThe 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...
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Albuquerque, United States Optum Full timeThe 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...
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