National Medical Director – Optum HouseCalls Clinical Field Operations – Remote

For those who want to invent the future of health care, here’s your opportunity. We’re going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

Oversight of the National HouseCalls program which delivers in home annual wellness exam to all qualified Medicare Advantage Members, Community and State members and several other plans.

HouseCalls is a unique program designed to enhance and improve quality care for our members.  We provide in home assessments to members and tailor our care based on the individual and their health care needs.

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

Primary Responsibilities:

• Clinical Model Support:
  • Support clinical strategy, efficacy and effectiveness of HouseCalls referrals; internally and partner programs
  • Lead coordinating the ongoing HouseCalls value proposition studies through various values analytic initiatives and studies
  • eHouseCalls documentation improvements in partnership with clinical performance team
  • Oversight of CLIA waivers
  • Policies and Procedure support/review
  • Regulatory change implementation and review
  • Updating standards of care/protocols
  • Product and model development support
• Quality:
  • Individual quality of care case review
  • Review/guide QOC and peer review procedures
  • Credentialing
  • Partner with clinical performance team with documentation initiatives, helping to drive strategy
  • Stars initiatives
• Relationships:
  • Lead relationship with collab physicians (providing misguidance to APCs, non-compliance with requirements, help recruit/interview)
  • Outreach to PCP complaints regarding general HouseCalls concerns
  • Peer Review meetings/oversight
  • Engagement strategies with providers, members and health plan
  • Implementation of new clients
  • Ongoing support of relationship with health plan (QOC review, GPOC, etc.)
  • Vendor support (medical director)

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 degree
• Active, unrestricted physician state license
• Current board certification in ABMS or AOA specialty
• Clinical practice experience post residency
• Solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles

Preferred Qualifications:

• Hands-on utilization and/or quality management experience
• Project management or active project participation experience
• Substantial experience in using electronic clinical systems

*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, Washington, Washington, D.C. Residents Only: The salary range for this role 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 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.  

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.

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.