Medical Director Complex Health Solutions/ Special Needs Telecommute

Medical Director careers at UnitedHealth Group are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. Instead of seeing one patient at a time, you have the opportunity to impact health care trend across the population with data driven information and tools to promote evidence based care. Join us. And start doing your life's best work.(sm)We are currently seeking a Medical Director, Complex Health Solutions/ Special Needs. The Medical Director will take a family centric approach to help the health system work better and to promote best in class care management. This includes meeting with external stakeholders, program and product design improvement, site related audits, and improvement initiatives.You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challengesPrimary Responsibilities:As the team’s Clinical Leader, Medical Directors:

Serve as the lead physician partnering closely with medical management team leaders

Promote and communicate the Complex Health Solutions mission, vision, business strategy through daily work and a recognition and desire to maximize the medical benefits for our members

Participates in periodic clinical conferences / calls and in ongoing internal performance consistency reviews

Participate in customer and consultant presentations, participate in audits, retention efforts, and respond to questions related to clinical performance

Serve on project teams as a leader, participant, and/or consultant; collaborate with internal business partners to promote value levers and other strategic initiatives

Passion for working with individuals or families with medically complexities

Provide leadership and support for CHS clinicians in:

Serve to develop, improve, and evaluate the critical thinking skills of the nurses, other clinicians and family support consultants, to achieve the highest quality and efficiency outcomes for our pediatric and complex adult populations

Clinical opportunity identification, intervention, and care plan development

Promotion of use of network providers, UnitedHealth Care Premium Providers, or other quality rated physicians

Composes, if needed, patient situation specific, clinical summaries and rationales for medical necessity decisions

As a Medical Director:

Perform peer to peer discussions when indicated which promote optimal health and well-being of the individual members

Through one-on-one discussions as well as Medical Director Value Case Reviews with nursing staff, stimulate critical thinking, assist in identification of clinical gaps, and coach staff on communication with providers and on care plan development/recommendations

Direct coordination and management of complex care issues in conjunction with families physicians and proposes care plans to prevent avoidable readmission, clinical morbidity and mortality

In conjunction with Clinical Managers, work to improve the nurse knowledge base and management of cases through site leadership meetings, clinical teaching sessions, team meetings, case audits, nurse tools, and one-on-one case discussions

Knowledge of medical expense spending and administrative complexity that would drive changes in focus at the case level

Alert UHC Medical Directors to provider issues of compliance with UHC protocols, over utilization, quality of care issues, and lack of adherence to Evidence Based Medicine guidelines

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:

MD or DO with an active, unrestricted medical license

Current Board Certification in an ABMS or AOBMS specialty

3+ years of clinical practice experience

Previous administrative leadership experience

Excellent written and oral communication skills with customer facing experience

Excellent project management skills

Solid data analysis and interpretation skills; Ability to focus on key metrics

Proficiency with Microsoft Office applications

Preferred Qualifications:

Managed care experience, including UM, CM, Affordability / Cost savings initiatives, Quality Management experience

Board certification in Internal Medicine, Family Medicine, or Pediatrics

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.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.Job Keywords: Medical Director, Complex Health Solutions, Telecommute