Michigan Regional Medical Officer - Oakland County, MI or Telecommute

Company: Optum
Location: Southfield
Posted on: August 3, 2022

Job Description:

Medical Director opening in Southfield, Michigan. This and other physician jobs brought to you by DocCafe

Regional Medical Officer Oakland County, MI

Work Remote/Home Based



Landmark Health, part of the Optum and UnitedHealth Group family of businesses, was created to transform how healthcare is delivered to the most medically vulnerable members in our community. Our medical group provides home-based medical care to chronically ill patients, many of whom are ill-equipped to navigate our overwhelming healthcare system.



Objective
The Regional Medical Officer will serve as a key member of the regional leadership team. He/she will directly report to the Chief Clinical Officer but also have dual reporting to the Regional RVP General Manager. He/she will work closely with the Landmark division leadership team, having primary responsibility to provide clinical direction and manage Landmark's clinical development initiatives in order to further growth, ensure high quality patient care, enforce standardization, define strategy and ensure excellence in client relations and meetings of all financial, operational, and quality metrics.



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



Primary Responsibilities:

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• Lead as an active and hands-on member of the senior management team to plan and execute adjustments to the clinical delivery model and operations to meet changing needs
  
• Develop clinical programs, oversee medical management, and drive quality improvement efforts. Provide leadership, direction, and administration of clinical operations to ensure compliance with Landmark objectives towards the realization of quality, cost-effective health care services
  
• Work with the division leadership team to set utilization goals, operational and quality metrics
  
• Oversee and accountable for region's performance on established clinical and quality outcomes
  
• Monitor metrics to identify opportunities for process improvements and/or staff education to produce optimal outcomes
  
• Enforce and ensure standardization of clinical workflows of the provider team across the region
  
• Responsible for oversight on hiring and training of Market Medical Directors in partnership with the Market Executive Director
  
• Responsible for managing, coaching, and retaining Market Medical Directors in the region
  
• Provide education and share best practices: Landmark Way trainings, additional staff education, and coordinate education sessions with outside agencies
  
• Participate in telephonic on-call coverage that require telephonic triage on an as needed basis
  
• Work closely with Market Medical Directors to address recruiting and retention challenges of provider team in their respective market
  
• Develop, manage and accountable for relationships with health plan business partners with the support of operational counterparts
  
• Develop, manage and accountable for relationships with high volume community provider partners that cross multiple markets in the region
  
• Attend and participate in meetings: Quarterly Business Review, contracted health plan Joint Operating Committee and selective Joint Executive Committee, Market and Regional Leadership Team, Provider and Physician, and other meetings as required
  
• Participate in the development of budgets, staffing plans, medical loss ratio projections, and assuring the adequate allocation of resources to medical management functions
  
• Strategize on new market business opportunities, working collaboratively with Regional Leadership and Business Development team
  
• Assign Landmark clinical resources to meet stakeholders' expectations - health plans, members, family members and Landmark colleagues
  
• Lead in areas of utilization management, clinical quality improvement, case management, provider relations, concurrent review, and disease management
  
• In partnership with the national leader of Health Services, manage NCQA, URAC, and AHCA qualification activities. Prepare for site visits and responds to accrediting and regulatory agency feedback
  
• Oversee risk management, claim adjudication, pharmacy utilization management (in partnership with director of pharmacy), catastrophic case review, outreach programs, HEDIS reporting, site visit review coordination, triage, nutrition service review, provider orientation, credentialing, etc.
  
• Implement and monitor structures and processes which are measurable and flex/change those processes as needed to meet financial, operational, and quality goals
  
• Maintain up-to-date knowledge of new information and technologies in medicine and their application to the patient population
  
• Support Market Medical Director in patient care by consulting on the most complex patients in the region
  
• Participate in targeted ride alongs with providers as well as targeted comprehensive chart reviews in order to audit and coach selected providers
  
• Collaborate with shared services on special projects and company wide initiatives
  
• Cross cover for Market Medical Director as warranted
  
• Other duties assigned
  
  
  
  
  Supervisory:
  
  
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  • Reports directly to the Chief Clinical Officer with dual reporting to the Regional RVP General Manager
    
    
    
    
    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:
    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    
    
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    • MD/DO from an accredited medical school
      
    • Board Certification, preferably in emergency medicine, family practice or internal medicine
      
    • Unrestricted license to practice medicine
      
    • Travel by car and plane 25%+
      
    • Access to reliable transportation
      
    • Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance
      
      
      Preferred Qualifications:
      
      
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      • 10+ years of clinical / management experience in health care
        
      • Possess leadership and people management skills and successfully demonstrated the ability to build and develop a solid medical management team
        
      • Home Health Care
        
      • Superior clinical decision-making skills
        
      • Superior reasoning, planning, and time management skills
        
      • Superior verbal and written communication skills
        
      • Superior multi-tasking skills, detail oriented
        
      • Superior organization skills
        
      • Self-starter, proactive, works quickly and accurately
        
      • Experience developing and managing clinical programs, focused on the chronically ill and managing medical expense
        
      • In depth knowledge and experience working within and/or in partnership with health plans and health systems
        
      • Deep experience in informatics and analytics
        
      • Experience in quality assurance, utilization review, and program development coupled with solid implementation skills
        
      • Knowledge in systems caring for highly complex patient populations
        
        
        Physical Demands:
        Below are the physical requirements which are representative of those that must be met by the employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
        
        
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        • Regular requirement to sit; use hands to touch, handle or feel.
          
        • Regular requirement to talk and listen.
          
        • Occasional requirement to stand; walk and reach with hands and arms
          
        • Occasional requirement to lift and/or move up to 10 pounds.
          
        • Vision abilities include close vision, peripheral vision, depth perception and ability to adjust focus.
          
        • Ability to travel by plane or car
          
          
          Work Environment:
          Below is a description of the work environment that the employee will encounter while performing the essential functions of the job.
          
          
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          • Noise level is usually moderate
            
            
            
            
            Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $254,600.00 to $295,200.00. The salary range for Connecticut / Nevada residents is $254,600.00 to $295,200.00. The 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.
            
            
            
            *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
            
            
            
            To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
            
            
            
            
            
            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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Keywords: Optum, Southfield , Michigan Regional Medical Officer - Oakland County, MI or Telecommute, Accounting, Auditing , Southfield, Michigan