Administration - Management Job at Optum in Albuquerque, NM
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, and quality improvement.
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 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, or ability to obtain license.
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 or eligible to obtain. 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 abilities
Excellent understanding of medical group financial concepts, including revenue cycle, physician compensation models, and preferably including managed care financial concepts (capitation, IBNR, MLR)
Why Albuquerque?
300 days a year of sun-drenched and picturesque mountain views
Enjoy all seasons with mild winters
A Top City with the Cleanest Air in America, Thrillist
Top destination for hiking, biking, skiing and running
Top 10 ranking for Americas Best Cities for Foodies, Travel + Leisure
Diverse Culture Art galleries, theater, concerts, shopping, music venues
A Top Big Best Cities for Active Families, Outdoor Magazine
Top 5 ranking for Secretly Cool Cities, Huffington Post
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.
Apply Now
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 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, or ability to obtain license.
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 or eligible to obtain. 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 abilities
Excellent understanding of medical group financial concepts, including revenue cycle, physician compensation models, and preferably including managed care financial concepts (capitation, IBNR, MLR)
Why Albuquerque?
300 days a year of sun-drenched and picturesque mountain views
Enjoy all seasons with mild winters
A Top City with the Cleanest Air in America, Thrillist
Top destination for hiking, biking, skiing and running
Top 10 ranking for Americas Best Cities for Foodies, Travel + Leisure
Diverse Culture Art galleries, theater, concerts, shopping, music venues
A Top Big Best Cities for Active Families, Outdoor Magazine
Top 5 ranking for Secretly Cool Cities, Huffington Post
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.
Apply Now