Optum New Mexico - IPA Medical Director

Optum NM is seeking a IPA Medical Director to join our team in Albuquerque, NM. 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 Clinical Medical Director (CMD) is responsible for implementation of The Group's long and short term strategic healthcare initiatives, designing and implementing viable clinical services and programs to deliver quality healthcare to our community. Approved strategic initiatives will be designed to keep the organization in the forefront of the changing national healthcare industry as well as demonstrating clinical leadership in the local market. The CMD will serve as a valuable clinical resource for information and consultation on issues related to clinical services, medical policy, practice guidelines and clinical review of technology. Responsible for providing Utilization Management clinical reviews as needed. Ensure all established clinical guidelines are adhered to. Other accountabilities will be implementing continuous quality improvement and educational programs for Providers, developing procedures/guidelines for managing the clinical and financial risk of coordinated care, overseeing quality accreditation initiatives and participating in the development of quality and productivity incentive programs for Providers. Adheres to policies, procedures and regulations to ensure compliance and patient safety. Participation in Compliance and other important training is a condition of employment.

DIRECTOR AND MANAGER COMPETENCIES:

• Aligning Performance for Success: Focuses and guides others in accomplishing work objectives
• Gaining Commitment: Uses appropriate interpersonal styles and techniques to gain acceptance of ideas or plans; modifies one's own behavior to accommodate tasks, situations, and individuals involved
• Selecting Talent: Evaluates and selects internal and external talent to ensure the best match between the individual and the work requirements
• Strategic Decision-Making: Obtains information and identifies key issues and relationships relevant to achieving a long-range goal or vision; commits to a course of action to accomplish a long-range goal or vision after developing alternatives based on logical assumptions, facts, available resources, constraints, and organizational values
• Patient Relations: Meets patient and patient family needs; takes responsibility for a patient's safety, satisfaction, and clinical outcomes; uses appropriate interpersonal techniques to resolve difficult patient situations and regain patient confidence
• Business Acumen: Uses economic, financial, market, and industry data to understand and improve clinic business results; uses one's understanding of major business functions, industry trends, and The Group's position to contribute to effective business strategies and tactics
• Developing Others: Plans and supports the development of individuals' skills and abilities so that they can fulfill current or future job/role responsibilities more effectively
• Leadership Disposition: Demonstrates the traits, inclinations, and dispositions that characterize successful leaders; exhibits behavior styles that meet the demands of the leader role
• Planning and Organizing: Establishes courses of action for self and others to ensure that work is completed efficiently

Primary Responsibilities:

• Provides leadership to the Group in the design and implementation of strategic healthcare initiatives such managed care services within the community, the implementation of new clinical services within the Group, and the redesign of current clinical and professional services
• Researches and recommends new healthcare service opportunities, keeping the Group ahead of changing national healthcare requirements and/or legislation, as well as anticipating and responding to the needs of the local community for healthcare
• Supports the Chief Operating Officer (COO) in the development and implementation of managed care operational processes as necessary
• Serves as an internal consultant to the Group in the development of managed care risk contracts and to physicians in the successful case management of patients under various managed are risk arrangements
• Supports the COO in the development and implementation of managed care operational processes as necessary
• Assists in the presentation of reports on managed care, health and quality improvement issues, as determined by the President
• Build, grow, and maintain relationships between The Group and hospitals, health plans, and other medical organizations as necessary
• Performs other duties as assigned

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:

• Current MD/DO medical license in the state of New Mexico
• Board Certified in Specialty or Primary Care, or in the process of obtaining certification unless granted an exemption by Credentialing Committee and/or Board of Governors
• New Mexico Pharmacy/DEA Registration if applicable to practice
• 2+ years of experience at senior leadership level in medical group or network; five (5) years' experience as a practicing physician preferably in a medical group

Preferred Qualifications:

• Master's Degree in related field
• Experience in both fee-for-service and managed care operations
• 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)
• Ability to comfortably use Microsoft Word, Excel, and PowerPoint
• Proven excellent communication skills, both verbal and written

The salary range for this role is $269,500 to $425,500 annually based on full-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.

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.