Medical Director

4 weeks ago

Atlanta, Georgia, United States Optum Full time

Optum Medical Director Job Description

At Optum, we are creating a new model of care that addresses the physical, mental, and social needs of our patients. As a Medical Director, you will play a key role in this effort, working with our team to develop and implement care coordination strategies that improve patient outcomes and reduce costs.

Key Responsibilities:

  • Provide daily utilization oversight and external communication with network physicians and hospitals
  • Conduct daily UM reviews, authorizations, and denial reviews
  • Conduct peer-to-peer conversations for clinical case reviews, as needed
  • Communicate effectively with network and non-network providers to ensure the successful administration of Care Transitions' services
  • Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers
  • Represent Optum on external levels, identifying, engaging, and establishing/maintaining relationships with other thought leaders
  • Collaborate with Client Services Team to ensure a coordinated approach to delivery system providers
  • Contribute to the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals
  • Interact, communicate, and collaborate with network and community physicians, hospital leaders, and other vendors regarding care and services for enrollees
  • Provide leadership and guidance to maximize cost management through close coordination with all network and provider contracting
  • Regularly meet with Optum's leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues
  • Provide input on local needs for Analytics Team and Client Services Team to better enhance Optum's products and services
  • Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME
  • Participate on the Medical Advisory Board
  • Provide intermittent, scheduled weekend and evening coverage
  • Perform other duties and responsibilities as required, assigned, or requested

Requirements:

  • Board certification as an MD, DO, MBBS with a current unrestricted license to practice and maintain necessary credentials to retain the position
  • Current, unrestricted medical license and the ability to obtain licensure in multiple states
  • 3+ years of post-residency patient care, preferably in inpatient or post-acute setting

Preferred Qualifications:

  • Licensure in multiple states
  • Willing to obtain additional state licenses, with Optum's support
  • Understanding of population-based medicine, preferably with knowledge of CMS criteria for post-acute care
  • Demonstrated ability to work within a team environment while completing multiple tasks simultaneously
  • Demonstrated ability to complete assignments with reasonable oversight, direction, and supervision
  • Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals
  • Demonstrated competence in use of electronic health records as well as associated technology and applications
  • Proven excellent organizational, analytical, verbal, and written communication skills
  • Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues
  • Proven highest level of ethics and integrity
  • Proven highly motivated, flexible, and adaptable to working in a fast-paced, dynamic environment

  • District Medical Director

    4 weeks ago

    Atlanta, Georgia, United States One Medical Full time

    About UsOne Medical is a primary care solution that's redefining the industry by making quality care more accessible and enjoyable. Our mission is to transform healthcare by improving the experience for everyone involved - from patients and providers to employers and health networks. We're committed to delivering exceptional health care to more consumers,...

  • District Medical Director

    4 weeks ago

    Atlanta, Georgia, United States One Medical Full time

    About the RoleWe are seeking a highly skilled District Medical Director to join our team at One Medical. As a key member of our leadership team, you will be responsible for cultivating a strong, engaged, and empowered team, maintaining and fostering clinical excellence, and supporting the district's business performance in collaboration with operations...

  • Medical Director

    4 weeks ago

    Atlanta, Georgia, United States Concentra Full time

    Job SummaryConcentra is seeking a skilled Medical Officer to join our patient care team. As a vital member of our team, you will play a crucial role in providing exceptional care to our patients.Key ResponsibilitiesPerform medical assessments of Center patientsEstablish and monitor a medically appropriate level of care for center patientsMeet with employers...

  • Veterinary Medical Director

    4 weeks ago

    Atlanta, Georgia, United States The Vet LLC Full time

    The Vet LLC is seeking a skilled Veterinary Medical Director to lead our hospital team in providing top-tier healthcare and wellness services to pets and their families.This is an excellent opportunity for a veterinarian who is passionate about providing high-quality care in a collaborative and community-focused environment.Key qualifications include:Doctor...

  • Medical Director

    4 weeks ago

    Atlanta, Georgia, United States Samuel Contract Staffing Full time

    Medical Director OpportunityWe are seeking a visionary Medical Director to lead our medical services in Atlanta, GA. As a compassionate leader, you will oversee our healthcare team and develop strategies to enhance the quality of care and improve patient outcomes.Responsibilities:Provide clinical leadership and direction to our healthcare team.Develop and...

  • Medical Director of Addiction Services

    1 month ago

    Atlanta, Georgia, United States Amaya Staffing Consultants LLC Full time

    Job Title: Medical Director of Addiction ServicesAmaya Staffing Consultants LLC is seeking a highly qualified Medical Director of Addiction Services to join our team. The ideal candidate will have a strong background in psychiatry and expertise in treating individuals with co-occurring mental health and substance use disorders.Responsibilities:Administrative...

  • Medical Director Opportunity in Atlanta

    4 weeks ago

    Atlanta, Georgia, United States Healthcare Connections Full time

    Medical Director Opportunity in AtlantaWe are seeking a highly skilled Internal Medicine Physician to join our team at Healthcare Connections in Atlanta. As a Medical Director, you will be responsible for leading our team of healthcare professionals and providing exceptional patient care.Key Responsibilities:Lead a team of healthcare professionalsProvide...

  • Medical Director of Addiction Services

    1 month ago

    Atlanta, Georgia, United States Amaya Staffing Consultants LLC Full time

    Job Title: Medical Director of Addiction ServicesJob Summary:We are seeking a highly qualified and experienced Medical Director to lead our addiction services team. The ideal candidate will have a strong background in addiction medicine and a proven track record of success in leading medical teams.Responsibilities:Administrative Oversight:Oversee and lead...

  • Medical Director

    1 month ago

    Atlanta, Georgia, United States Innova Solutions Full time

    Job Title: Medical Director - Utilization ReviewInnova Solutions is seeking a highly skilled Medical Director to lead our Utilization Review team. As a key member of our clinical leadership team, you will be responsible for overseeing the review of medical necessity and appeal decisions, ensuring that our clients receive high-quality care while minimizing...

  • Medical Director

    4 weeks ago

    Atlanta, Georgia, United States Grady Health System Full time

    Job Title: Medical Director - Population Health LeaderJob Summary: Grady Health System seeks a Medical Director to lead its population health programs. The ideal candidate will have experience in clinical leadership, population health, and healthcare management. The Medical Director will oversee the development and implementation of clinical programs and...

  • Senior Medical Director

    4 weeks ago

    Atlanta, Georgia, United States Serenity Healthcare, LLC Full time

    Senior Medical Director - PsychiatrySerenity Healthcare, LLC is seeking an experienced Medical Director to lead our psychiatric services in an administrative and clinical capacity. As a company leader, your role will include:Mentorship and guidance of other providersCreation and implementation of best practicesLeadership of a successful interventional...

  • Director of Quality and Medical Staff

    4 weeks ago

    Atlanta, Georgia, United States Emory HealthcareEmory University Full time

    Emory University School of Medicine's Department of Pathology and Laboratory Medicine seeks a Director of Anatomic Pathology / Surgical Pathology based at Grady Memorial Hospital.This renowned public academic hospital serves Atlanta and its surrounding communities.Grady's anatomic pathology division handles approximately 14,000 surgical pathology specimens,...

  • Medical Director

    4 weeks ago

    Atlanta, Georgia, United States Emory University Full time

    Emory University is a leading research institution that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future.We welcome candidates who can contribute to the diversity and excellence of our academic community.The Gastroenterology Clinical Director will be committed to serving patients, providers, staff, and...

  • Thoracic Surgeon

    4 weeks ago

    Atlanta, Georgia, United States Sterling Physician Recruiters Llc Full time

    Thoracic Surgeon / Medical Director OpportunitySeeking a highly skilled Thoracic Surgeon to lead our established Thoracic Surgical / Lung Cancer Program at a non-profit community hospital in NE Georgia. This respected cancer care center offers extensive state-of-the-art healthcare facilities and a collaborative environment for clinical research and...

  • Medical Director

    4 weeks ago

    Atlanta, Georgia, United States Envision Physician Services - EMHM Full time

    Envision Physician Services - EM/HM is seeking a Medical Director to lead our Critical Care/Hospitalist team at Select Specialty Hospital - Midtown Atlanta.**Job Summary:**We are seeking a highly skilled and experienced Medical Director to join our team. The ideal candidate will have a strong background in critical care and hospital medicine, with excellent...

  • Medical Director

    4 weeks ago

    Atlanta, Georgia, United States Serenity Healthcare, LLC Full time

    Serenity Healthcare, LLC is seeking an experienced Medical Director to lead our psychiatric outpatient practice in an administrative and clinical capacity. As a company leader, your role will include mentorship and guidance of other providers, creation and implementation of best practices, and overseeing growth strategies.Requirements:Board Certified or...

  • Veterinarian Medical Director Position

    4 weeks ago

    Atlanta, Georgia, United States Korzen Health Full time

    Korzen Health, a leading healthcare provider, is seeking a highly skilled Veterinarian Medical Director to join their team. This is an exceptional opportunity for a dedicated professional to lead a state-of-the-art veterinary hospital in the greater Atlanta area.The hospital boasts a strong reputation, having been voted best in the area in 2023. With a loyal...

  • Medical Director for Medicaid Appeals and Optimization

    4 weeks ago

    Atlanta, Georgia, United States Elevance Health Full time

    Job DescriptionJob Title: Medical Director for Medicaid Appeals and OptimizationLocation: Hybrid position, must live within 50 miles of an Elevance Health locationAbout the Role:We are seeking a highly skilled Medical Director to lead our Medicaid Appeals and Optimization team. As a key member of our organization, you will be responsible for ensuring that...

  • Medical Director

    4 weeks ago

    Atlanta, Georgia, United States The Terraces at Peachtree Hills Place Full time

    Job Title: Medical DirectorJob Summary:We are seeking an experienced and compassionate Medical Director to lead our geriatric care team at The Terraces at Peachtree Hills Place. The ideal candidate will have a strong background in geriatric medicine and a commitment to providing exceptional primary care to our elderly patients.Key Responsibilities:Primary...

  • Medical Director Opportunity in Atlanta Metro Area

    4 weeks ago

    Atlanta, Georgia, United States Sterling Physician Recruiters, LLC Full time

    Seeking a Medical Director to lead our established primary care practice group in the Atlanta Metro area. Our team is supported by exceptional leadership and clinical teams, providing a collaborative environment for success.As a Medical Director, you will have the opportunity to lead a team of 18 providers across 5 clinics, with a comprehensive patient care...