Network Medical Director

Optum Health MidAmerica is seeking an experienced Medical Director to join their team, focusing on care transformation within their contracted network. This role involves improving health outcomes by connecting individuals with essential care, pharmacy benefits, data, and resources. The Medical Director will provide expertise in population health, risk adjustment, and quality, working collaboratively to enhance contracted PCP group engagement and performance in Value Based Care delivery.

Practice Info

• Located within South Carolina or Georgia, with willingness to travel across state lines to visit practice locations.
• Field-based position requiring frequent face-to-face meetings with local network medical practices.
• Flexibility to work remotely if located in TN, GA, VA, SC, in addition to field work.

Responsibilities

• Build, maintain, and manage market stakeholder relationships across multiple layers and functions.
• Lead and support physician-to-physician discussions and problem-solving with various medical leaders and service providers.
• Assist analytical efforts to identify and quantify new opportunities to improve the value of services delivered.
• Collaborate in teaching clinicians and clinical operations teams about Medicare Risk Adjustment, CMS STARs/HEDIS, and overall population health approach to patient care.
• Establish and maintain evidence-based standards for clinical documentation and care coordination activities.
• Navigate professional body guidelines, published literature, coding rules, and regulations to provide thought leadership and recommended actions to physicians.
• Establish solid and lasting, trust-based relationships within the team and with external partners.
• Conduct deep dive program reviews with relevant internal and/or external stakeholders to identify opportunities for continuous improvement.

Compensation

• The salary for this role will range from $248,500 - $373,000 annually based on full-time employment.

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Requirements

• M.D. or D.O. degree
• Current unrestricted license to practice medicine
• Board certified in Internal Medicine, Family Medicine, or Critical Care
• 5+ years of clinical experience
• Proven solid presentation and persuasion skills; ability to speak clearly and lead discussions with senior executives and large groups
• Demonstrated ability to influence without authority
• Willing or ability to travel, with occasional overnight travel
• Demonstrated ability to implement complex programs and monitor implementation and necessary modifications
• 2+ years of experience in a physician leadership role in medical facility or related environment (Preferred)
• General knowledge of clinical programs, trends and medical management, medical care delivery systems, utilization management, disease management, analytics quality management, contracting, provider relations and customer service (Preferred)