Sr. Medical Director, Optimal Care Specialist Engagement – Remote ($384K/yr – $561.6K/yr)

  • Full Time
  • Anywhere

About the job

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Enterprise Clinical Performance is charged with effectively designing, implementing, monitoring, and executing on clinical affordability programs and projects chartered with improving quality of care and achieving best in class clinical outcomes for our patients while reducing overall costs across providers within Optum Health. Optum Health is a ~ $95 billion a year organization, touching over 4.1 million patients in value-based care arrangements. Enterprise Clinical Performance provides support to all markets served by Optum Health.

The Sr. Medical Director, Optimal Care Specialist Engagement will report to the VP of Optimal Care and Clinical Technology. This position will be responsible for collaborating with other physicians engaged in the program, primarily specialists, to create/align evidence-based protocols, appropriate specialty outcomes metrics, working with local markets to engage with specialist groups, participating in continually evolving the Optimal Care strategy and driving deeper partnerships with Optum’s specialist businesses. In addition, this position will be responsible for driving the deployment of an integrated system of patient shared-decision making, patient reported measure collection and the integration of patient reported outcomes data back into the Optimal Care program. In pursuit of integrating PRO collection across Optum Health, this position will be responsible for collaborating across businesses to unify the collection of patient reported information across channels and align to one centralized source of said data, regardless of collection method. The focus of the Optimal Care program is on reducing unwarranted variation in clinical practice patterns and inefficient care through a system of interventions that supports the evidence-based/data-informed practice of medicine and monitors outcomes across providers. The work seeks to pull key decisions further up the delivery chain, align the decision with the right person, and support the decision-maker with the most up-to-date evidence, education, data, and tools necessary to make the best decision.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

  • The leader must be a deep subject matter expert in care delivery who can drive strategy and organizational alignment through collaboration, expertise and relationships
  • Strategic direction for CDO implementation and National intervention creation activities:
    • Broad patient reported data collection and the use of standard patient reported outcomes measures in clinical practice
    • The practical application of structured, approachable and measured shared-decision making strategies
    • Clinical and referral decision support pathways
    • Organizing and driving clinical research alongside partnering clinicians
    • Specialist and ancillary contracting, referral strategy, and engagement/alignment strategy in all markets
    • Point of service functionality for patient engagement and clinical decision support
    • Patient education, engagement and activation strategies and programs
    • Network management and incentive alignment strategy
  • Champion the quantitative and qualitative value of patient reported data collection across Optum Health
  • Partner across care delivery organizations and organized specialist groups (through Surgical Care Affiliates or Optum Specialty Practices) to develop unified system of patient engagement and patient reported data collection
  • Provide clinical direction, thought leadership and input into the strategy of the Optimal Care program
  • Given the complex nature of Optum Health, the ability to achieve goals through a combination of direct and indirect influence will be critical
  • Lead through influence the medical leadership of varying businesses and their corresponding hierarchies across the country to achieve strategic objectives
  • Assist in increasing collaboration and driving results across Optum Health within patient engagement strategies
  • Align with national standards and medical expectations as they relate to eliminating avoidable and wasted care
  • Bring clinical thought leadership and drive the broader Optimal Care team to identify new areas of low value/inefficient care and improved measurement techniques
  • Encourage building strong collaborative relationships with leadership and medical management resources across Optum Health and key partners throughout the organization
  • Promote understanding of Evidence Based Medicine, clinical best practices, market trends and patient and provider needs related to care delivery, medical management and clinical affordability
  • Promote an environment of understanding of the market nuances to drive cross functional team synergy
  • Ensure compliance with all requirements (e.g., CMS, NCQA, Health Plan, state)

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.B.A, M.P.H or other advanced training outside of clinical specialty
  • M.D. or D.O. Board Certified in a post graduate clinical specialty; musculoskeletal specialties preferred
  • 15+ years of experience in the healthcare industry as a specialist
  • Extensive experience collecting, interpreting, and applying patient reported outcomes to patient care and/or population health
  • Strategic expertise in the design, development, and deployment of clinical programs
  • Deep understanding of value-based payment systems, managed care systems, quality improvement and risk management
  • Demonstrated ability to lead clinical decision support programs
  • Solid understanding of managed care systems, quality improvement and risk management
  • Demonstrated ability to research and synthesize findings into evidence-based protocols
  • Demonstrated ability to work in a highly matrixed organization
  • Knowledgeable on delegation in managed care and on strategies applied by successful risk bearing entities
  • Demonstrated solid interpersonal skills and ability to build relationships
  • Demonstrated excellent presentation, writing, and negotiation skills
  • Proven ability to work with multiple stakeholders, with opposing points of view, and build consensus.
  • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $383,977 to $561,553 annually. 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 education, work experience, certifications, etc. 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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: 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.

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