Network Medical Director – St. Louis, MO – Midwest RBE – Field-based with Travel

Optum MO is seeking a Medical Director to join our team in St. Louis, MO.  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.

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.  

In support of OptumCare Midwest Region’s mission, vision, and strategic goal to achieve the quadruple aim by focusing on value-based care, the Network Medical Director provides clinical leadership in guiding network medical practices in the adoption of the key principles, tools, technologies, and clinical support services essential to the population health management in their designated market(s). This opportunity provides direction, coordination, support, and accountability to Primary care practices of various sizes, multispecialty groups, hospitals, and ancillary facilities. The Network Medical Director works collaboratively across a team to help foster contracted PCP group engagement and performance within the core fundamentals of Value Based Care delivery – STAR/HEDIS performance, risk coding and documentation, and affordability. This is an administrative role which works closely with the Client Services Team in driving risk performance, patient engagement, practice engagement with central supports like care management programs, analytic platforms, and wrap around care services. 

The Network Medical Director reports to the Chief Medical Office for the OptumCare Midwest Region.  This position requires you to be located within the greater St. Louis area and willing to travel within the state of Missouri with occasional overnight stays. It is a field-based position requiring frequent face-to-face interfacing will local network medical practices through the assigned state.

 Primary Responsibilities: 

• Leads onboarding discussions with new practices joining the network, focusing on setting appropriate and customized performance expectations in collaboration with the practice leaders
• Establishes and messages clear standards and expectations for the professional performance of the provider/provider groups in their designated market(s) of the Midwest Risk Bearing Entity (RBE)
• Collaborates in teaching clinicians and clinical operations teams about Medicare Risk Adjustment, CMS STARs/HEDIS, and overall population health approach to patient care in both formal presentations and off the cuff at impromptu opportunities
• Seeks to align Risk Adjustment, Quality, and Affordability initiatives internally and translate into ways network practices can actively engage in easily using these resources
• Operates with a tone of service and collaboration, leading their designated market(s)
• Collaboratively works with the clinical and operational staff of the practices to develop strategies and design solutions to improve the value of care, clinical outcomes, affordability, and patient experience
• Works with RBE leaders to support integration of Quality Improvement programs, Utilization Management reports, and Disease Management programs
• Reviews and trends group/provider performance data to identify and strategize opportunities for improved performance
• Reports out at the Value Based Care Council, Quality Committee, Regional Executive committee, or Provider Meetings as requested
• Travel within their assigned state(s) on a regular basis as needed with occasional overnight travel

What makes an Optum organization different?

• Be part of a best-in-class employee experience that enables you to practice at the top of your license  
• We believe that better care for clinicians equates to better care for patients 
• We are influencing change collectively on a national scale while still maintaining the culture and community of our local care organizations 
• Practice medicine autonomously, with the support, not restrictions, of a sustainable and thriving national health care organization

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.D, D.O., or M.B.B.S.
• Active unrestricted license to practice medicine in Missouri
• Board certification in Family or Internal Medicine
• 5+ years of recent clinic-based clinical practice experience after completing residency training
• 2+ years of experience in a physician leadership role in medical facility or related environment preferred Well-versed in guiding conversations with clinicians, operations teams, and executive leadership in various organizations
• Experience and knowledge of the local Missouri market
• Knowledge of managed care, including risk adjustment, affordability, quality (STARs/HEDIS), utilization management, care management
• Driver’s license and access to reliable transportation
• Ability to travel, with occasional overnight travel

Preferred Qualifications: 

• Recent clinical practice experience in a Primary Care based setting
• Advanced knowledge of Medicare Advantage and SNP/D-SNP programs
• Ability to quickly customize the conversation with contracted groups at various stages of population health development
• Proven track record of working well with Physicians, APRN, Physician Assistants, Coders, Schedulers, Managers, Directors, and Executives to assure care delivery is patient centered, timely, effective and evidence-based approach to clinical care across all Primary Care and specialty care participants
• Solid understanding of local market and healthcare landscape

The salary range for this role is $269,500 to $425,500 per year. 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.