Associate Medical Director

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Optum East , (formerly Optum Tri-State NY) is seeking a Part- Time Associate Medical Director, Risk Education to join our team in NY/NJ . Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone.

At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The Optum Health East region is seeking an experienced Part -Time clinician to support our Medicare risk adjustment education efforts. Working with the Medical Director for Risk Adjustment and the Chief Clinical and Value Officer in Optum East, this key physician will provide expertise in risk adjustment and clinical documentation education for the markets in the Optum Health East region. This role will be part of a team focused on supporting clinicians to provide the highest level of care possible.

This is a role that partners with external physicians and leaders and requires collaboration and the ability to build relationships across all levels of the organization to ensure goals are met. This physician will be comfortable interacting daily with clinicians of all levels, as well as frontline clinicians and operational staff.

If you are willing to 2-3 days on site to various locations, you will have the flexibility to work remotely* as you take on some tough challenges. This is a hybrid Part time role.

Primary Responsibilities:

• Provides ongoing, targeted mentoring and education to physicians and APCs on appropriate diagnosis coding and supporting documentation
• Delivers risk education sessions and materials for clinicians in both primary care and specialties
• Conducts organization-wide training on changes or updates to risk adjustment models
• Implements programs to ensure all diagnosed conditions and appropriate codes are supported by documentation in the patient chart
• Educates physicians and APCs on risk adjustment activities, HEDIS measures, and gaps in care
• Collaborates with the Medical Director, Risk Adjustment, to establish provider performance baselines and develop tailored improvement strategies
• Informs clinicians about Medicare risk adjustment changes and supports implementation of recommended actions
• Provides clinical support for embedded nurse practitioner programs
• Aligns and prioritizes clinical documentation education programs across the region
• Builds and manages stakeholder relationships across multiple layers and functions
• Monitors wraparound programs for effectiveness and assists in coordination and barrier resolution
• Participates in regulatory and accreditation activities as applicable
• Establishes trust-based relationships within teams and with external partners
• Fosters teamwork and a culture of continuous improvement and accountability
• Demonstrates initiative and a self-starting attitude to problem-solving
• Thrives in a collaborative, diverse team environment
• Uses data to influence and lead physicians and support staff through change
• Reduces barriers for program implementation teams and anticipates roadblocks
• Solves problems in a dynamic environment and adapts to evolving challenges
• Distributes performance reports and synthesizes insights for optimization
• Conducts program reviews to identify opportunities for continuous improvement
• Collaborates on innovative and scalable program ideas
• Aligns with team members on expectations and material preparation
• Provides senior management with thoughtful analysis to support decision-making
• Travels locally to provider locations as needed
• Performs other duties as assigned, including early morning and evening meetings

Optum NY/NJ was formed in 2022 by bringing together Riverside Medical Group, CareMount Medical and ProHealth Care. The regional alignment combines resources and services across the care continuum – from preventative medicine to diagnostics to treatment and beyond across New York, New Jersey, and Southern Connecticut. As a Patient Centered Medical Home, Optum NY/NJ can provide patient-focused medical care to the entire family. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Together, we’re making health care work better for everyone.

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:

• M.D. or D.O. degree
• Current unrestricted license to practice medicine
• Board certified in Family Medicine, or Internal Medicine
• 5+ years of clinical experience
• Direct experience with Risk Adjustment diagnosis coding as a provider
• Solid knowledge of electronic health records, including experience in chart review
• Demonstrated ability to influence without authority
• Demonstrated ability to successfully operate in a dynamic and changing environment
• Demonstrated ability to implement complex programs and monitor implementation and necessary modifications
• Demonstrated ability to manage multiple priorities and deadlines in an expedient and decisive manner
• Proven innovative thought process and problem-solving skills
• Demonstrated solid presentation skills; ability to achieve change management in a matrixed environment; ability to speak clearly and lead discussions with senior executives and large groups
• Demonstrated solid verbal and written communication skills
• Willing or ability to continue to see primary care patients

Preferred Qualifications:

• Proven solid baseline knowledge of Risk Adjustment, and other Pay for Performance Programs
• Demonstrated ability to understand and navigate the organization’s culture; able to think both strategically and tactically; respected by peers; maintains competency and enhances professional growth and development through continuing education; general understanding of disparate systems and integration/information flow
• Demonstrated ability to form solid relationships with peers in practice, and leadership
• Proven credibility among the medical staff as a provider
• Proven belief in and enthusiasm for the role of Pay for Value to improve the delivery of care
• Proven effective listening and negotiating skills and patience

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

The salary range for this role is $104,500 to $156,000 annually based on Part-time employment. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

Seniority level

• Seniority level

  Director

Employment type

• Employment type

  Part-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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