Network Medical Director - St Louis, MO - Midwest RBE - Remote with Travel - Optum

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In support of the Midwest Region Risk Bearing Entity (RBE) mission, vision, and strategic goals to achieve the quadruple aim by focusing on value-based care, the Network Medical Director provides clinical leadership in the adoption of the key principles, tools, technologies, and clinical support services essential to the population health management of their designated market(s). This opportunity provides direction, coordination, support, and accountability to Primary care practices of various sizes, multispecialty groups, hospitals, and ancillary facilities. The Network Medical Director works collaboratively across the team to help foster network group engagement and performance within the core fundamentals of Value Based Care delivery. This is an administrative role which supports the Network Management Team regarding all elements of performance throughout the network, including adherence to quality performance, timely access for patients, appropriate and accurate documentation and coding, patient engagement, practice engagement with central supports like care management programs, analytic platforms, wrap around care services. 

The Network Medical Director reports to the Senior Medical Director for the Midwest RBE.  

If you are located in St. Louis area, you’ll enjoy the flexibility to work remotely *as you take on some tough challenges. This position requires you to be located within the St. Louis area and willing to travel within the region with occasional overnight stays. 

Primary Responsibilities: 

Medical Leadership

• Leads onboarding discussions with new practices joining the network, focusing on setting appropriate and customized performance expectations in collaboration with the practice leaders
• Establishes and messages clear standards and expectations for the professional performance of the provider/provider groups in their designated market(s) of the Midwest RBE
• Collaborates in teaching clinicians and clinical operations teams about Medicare Risk Adjustment, Star ratings, and overall population health approach to patient care in both formal presentations and off the cuff at impromptu opportunities
• Seeks to align Risk Adjustment, Quality, and Affordability initiatives internally and translate into ways network practices can actively engage in easily using these resources
• Operates with a tone of service and collaboration, leading their designated market(s) in a dyad partnership with the Client Services Directors and designated Account Managers
• Collaboratively works with the clinical and operational staff of the practices to develop strategies and design solutions to improve the value of care, clinical outcomes, affordability, and patient experience 
• Works with RBE leaders to support integration of Quality Improvement programs, Utilization Management reports, and Disease Management programs
• Reviews and trends group/provider performance data to identify and strategize opportunities for improved performance
• Reports out at the Value Based Care Council, Quality Committee, Regional Executive committee, or Provider Meetings as requested
• Travel within their assigned state(s) on a regular basis as needed with occasional overnight travel.

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, D.O., or M.B.B.S
• Board certification approved by the American Board of Medical Specialties (ABMS)
• Active unrestricted license to practice medicine in Missouri
• Current unrestricted driver’s license
• 5+ years of recent clinical practice experience after completing residency training
• Experience and knowledge of the local market
• Willing or ability to travel, with occasional overnight travel

Preferred Qualifications:  

• 2+ years of experience in a physician leadership role in medical facility or related environment preferred Well-versed in guiding conversations with clinicians, operations teams, and executive leadership in various organizations
• Knowledge of managed care, including risk adjustment, affordability, quality, utilization management, care management, quality
• Advanced knowledge of Medicare Advantage and SNP/D-SNP programs
• Proven ability to quickly customize the conversation with contracted groups at various stages of population health development
• Proven track record of working well with Physicians, APRN, Physician Assistants, Coders, Schedulers, Managers, Directors, and Executives to assure care delivery is patient centered, timely, effective and evidence-based approach to clinical care across all Primary Care and specialty care participants

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

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.   

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment