Clinical Medical Director
Company: Optum
Location: Albuquerque
Posted on: April 22, 2024
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Job Description:
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.
Keywords: Optum, Albuquerque , Clinical Medical Director, Executive , Albuquerque, New Mexico
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