National Accounts Medical Director California Bay area
Company: UnitedHealth Group
Location: Walnut Creek
Posted on: February 14, 2021
Job Description:
National Accounts Medical Director California Bay area
Compassion. It's the starting point for health care providers like
you and it's what drives us every day as we put our exceptional
skills together with a real feeling of caring for others. This is a
place where your impact goes beyond providing care one patient at a
time. Because here, every day, you're also providing leadership and
contributing in ways that can affect millions for years to come.
Ready for a new path? Learn more, and start doing your life's best
work. SM We are currently seeking a National Accounts Medical
Director in the California Bay area. The Medical Director will take
a member centric approach to help the health system work better and
to promote best in class care management. This includes meeting
with external stakeholders, program and product design improvement,
site related audits, and improvement initiatives. Primary
Responsibilities: As the team's clinical leader, Medical
Directors:
- Promote and communicate the mission, vision, business strategy,
and OPTUM value proposition to the staff through leadership
meetings, educational programs and documents, program and tool
development, and case discussions
- Work closely with Site Directors and Operations Product and
Channel Leads to meet site, channel, and product goals
- Serve to develop, improve, and evaluate the critical thinking
skills of the nurses, to achieve the highest quality and efficiency
outcomes
- Provide leadership, training, and coaching for nurses in:
- Clinical opportunity identification, intervention, and care
plan development
- Promotion of use of network providers, UnitedHealth Care
Premium Providers, or other quality rated physicians
- Internal partner referrals
- Risk management and quality of care issues
- Foster, create, and maintain a professional and respectful work
environment to boost staff morale, satisfaction, retention,
commitment, and engagement
- Review business metrics, trend reports, utilization metrics,
customer reports, and nurse and site performance metrics and
present analysis and recommend action
- Act as a consultant to the business leaders on clinical issues
related to the business model, value levers, and strategy / product
/ program development
- Participate in customer and consultant presentations,
participate in audits, sales, retention efforts, and respond to
questions related to clinical performance
- "On call" for questions and issues related to utilization and
medical expense reduction efforts for customers and
consultants
- Serve on project teams as a leader, participant, and/or
consultant; Collaborate with internal business partners to promote
value levers and other strategic initiatives
- Work collaboratively with customers on mutually defined
goals
- Serve as a resource and a frequently requested clinical expert
for outside prospects and customers by assisting the sales and
account management teams with client meetings
- Support community activities that enhance Community Relations
and Reputation As a Case Reviewer, Medical Directors:
- Perform peer to peer discussions when indicated which promote
optimal health and well-being of the individual
- Through one-on-one discussions as well as Medical Director
Value Case Reviews with nursing staff, stimulate critical thinking,
assist in identification of clinical gaps, and coach staff on
communication with providers and on care plan development
- Direct coordination and management of complex care issues in
conjunction with enrollees' physicians and proposes care plans to
prevent readmissions
- Encourage the principles of "6C" call conduct, Inductive Call
Anatomy, warm and engaging consumer interaction, call efficiency,
good case management principles, and focus on measurable
outcomes
- In conjunction with Clinical Managers, work to improve the
nurse knowledge base and management of cases through site
leadership meetings, clinical teaching sessions, team meetings,
case audits, nurse tools, and one-on-one case discussions
- Adhere to medical director performance metrics and
evaluations
- Knowledge of admission, readmission data, and overall medical
expense that would drive changes in focus at the case level
- Alert UHC Medical Directors to provider issues of compliance
with UHC protocols, over utilization, quality of care issues, and
lack of adherence to EBM guidelines
- Support quality reviews, inter-rater reliability sessions,
regulatory requirements, and accreditation and certification
efforts including performing audits and participating in quality
clinical improvement studies As a "Physician Liaison," Medical
Directors:
- Interact with Regions, Markets, Customers, and other UHG
Medical Directors, Sales, Account Management, Clinical Solutioning,
Health Plan Medical Directors, Network Management, and OptumHealth
partners to implement strategy implement products and programs,
acquire and retain customers, and improve the quality and outcomes
of the consumers navigating care delivered by the provider network
and to improve relationships between the organizations
- Attend Monthly Medical Expense Meetings by Region and assist
with regionally based Affordability Initiatives with a focus on
admission, readmission, and overall bed day management
- Understand and act upon Condition Specific drivers including
high cost claimants and consumers with a pattern of frequent
utilization
- Must be willing to work in the office as needed; however will
allow to work remotely several days per week You'll be rewarded and
recognized for your performance in an environment that will
challenge you and give you clear direction on what it takes to
succeed in your role as well as provide development for other roles
you may be interested in. Required Qualifications:--
- MD or DO with an active, unrestricted medical license in the
state of California
- Current Board Certification in an ABMS or AOBMS specialty
- 3+ years of clinical practice experience post residency
- Excellent written and oral communication skills with customer
facing experience
- Excellent project management skills
- Solid data analysis and interpretation skills; Ability to focus
on key metrics
- Proficiency with Microsoft--Office applications
- You will be provisioned with appropriate Personal Protective
Equipment (PPE) and are required to perform this role with patients
and members on site, as this is an essential function of this
role
- Employees are required to screen for symptoms using the
ProtectWell mobile app, Interactive Voice Response (i.e., entering
your symptoms via phone system) or a similar UnitedHealth
Group-approved symptom screener prior to entering the work site
each day, in order to keep our work sites safe. Employees must
comply with any state and local masking orders. In addition, when
in a UnitedHealth Group building, employees are expected to wear a
mask in areas where physical distancing cannot be attained.
Preferred Qualifications:--
- Board certification in Internal Medicine or Family
Medicine
- 2+ years of managed care experience, including UM, CM,
Affordability / Cost savings initiatives, Quality Management
experience, and/or administrative leadership experience Careers
with Optum.--Here's the idea. We built an entire organization
around one giant objective; make the health system work better for
everyone. So when it comes to how we use the world's large
accumulation of health-related information, or guide health and
lifestyle choices or manage pharmacy benefits for millions, our
first goal is to leap beyond the status quo and uncover new ways to
serve. Optum, part of the UnitedHealth Group family of businesses,
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. Optum, incredible
ideas in one incredible company and a singular opportunity to
do--your life's best work.(sm) *All Telecommuters will be required
to adhere to UnitedHealth Group's Telecommuter Policy. 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. Job Keywords: Medical Director, Board
Certified, Clinical Practice, Claims, Utilization Management,
Managed Care, Bay Area, CA, California, Telecommute, Remote
Business Segment Enterprise Clinical Services Our team members help
close the gap in health care. Take a closer look and see how Lisa
helps members navigate a complex health care system. We're
committed to diversity and inclusion in everything we do. It's
ultimately what helps us understand a variety of perspectives and
provide quality care to our diverse member population. If you're
interested in working for an organization that val--- A Nursing
career at UnitedHealth Group can be challenging, yet very rewarding
at the same time. Our Registered Nurses and Nurse Practitioners are
caregivers through and through. At UnitedHealth Group, they work in
a fast-paced environment directly wi--- At UnitedHealth Group we
utilize many avenues to find the right candidates to fill open
positions. One of which, involves asking our current employees to
refer the people they know that would be a good fit for the
company. Our employees have great in--- UnitedHealth Group is
committed to working with and providing reasonable accommodations
to individuals with physical and mental disabilities. If you need
special assistance or accommodation for any part of the application
process, please call 1-800-561-0861 and press or say 1 for
Applicant to be connected to Recruitment Services. Recruitment
Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through
Friday. UnitedHealth Group is a registered service mark of
UnitedHealth Group, Inc. The UnitedHealth Group name with the
dimensional logo, as well as the dimensional logo alone, are both
service marks for the UnitedHealth Group, Inc. 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.
Keywords: UnitedHealth Group, Walnut Creek , National Accounts Medical Director California Bay area, Executive , Walnut Creek, California
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