Optum California - Community Medical Director
Optum California - Community Medical Director
Optum
Pasadena, CA
See who Optum has hired for this role
The Community 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 support the delivery of 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. 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.
- 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.
- Maintains a dyad relationship with operational leadership to oversee 7 primary care clinical sites in West San Gabriel Valley (Sites located in cities of Pasadena, La Canada, Alhambra, San Gabriel and Temple City)
- Provides leadership to the Group in the design and implementation of strategic healthcare initiatives such as the implementation of new clinical services within the Group, and the redesign of current clinical and professional services
- Oversees and optimizes existing site processes (Clinical review, Evidence based clinical pathways, Quality performance, etc). Supports the Senior Medical Director (SMD) 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 Clinical and Operations leadership
- Oversee Specialty partner relationships and Joint Operating Meetings with select contracted specialists and specialty service providers
- Build, grow, and maintain relationships between The Group and hospitals, health plans, and other medical organizations as necessary
- Performs other duties as assigned
Required Qualifications
- Current MD/DO medical license in the state of California
- Board Certified or Board Eligible in Specialty or Primary Care, or in the process of obtaining certification unless granted an exemption by Credentialing Committee and/or Board of Governors
- California Pharmacy/DEA Registration if applicable to practice
- 2+ years of experience at senior leadership level in medical group or network; 5+ years ofexperience as a practicing physician preferably in a medical group
- Experience in both fee-for-service and managed care operations
- Thorough understanding of medical group business models and clinical processes
- Proven ability to comfortably use Microsoft Word, Excel, and PowerPoint
- Proven excellent communication skills, both verbal and written
- Proven excellent understanding of medical group financial concepts, including revenue cycle, physician compensation models, and preferably including managed care financial concepts (capitation, IBNR, MLR)
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
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Seniority level
Director -
Employment type
Full-time -
Job function
Health Care Provider -
Industries
Hospitals and Health Care
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