National Accounts Medical Director Atlanta GA

Company: UnitedHealth Group Inc
Location: Atlanta
Posted on: September 17, 2020

Job Description:

Improve the lives of others while doing your life's best work. SM National Accounts Medical Director Atlanta GA (877843) Medical Director careers at UnitedHealth Group are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. Instead of seeing one patient at a time, you have the opportunity to impact health care trend across the population with data driven information and tools to drive evidence based care. Join us. And start doing your life's best work.(sm)

We are currently seeking a National Accounts Medical Director in the Atlanta, GA area. The Medical Director will take a member centric approach to help the health system work better and to promote best in class care management. This includes meeting with external stakeholders, program and product design improvement, site related audits, and improvement initiatives.

If you are located in the Atlanta, GA area, you will have the flexibility to telecommute, but required to meet in the Atlanta office at least two times per week, as you take on some tough challenges.

Primary Responsibilities:

As the team’s Clinical Leader, Medical Directors:

Promote and communicate the mission, vision, business strategy, and Optum value proposition to the staff through leadership meetings, educational programs and documents, program and tool development, and case discussions

Work closely with Site Directors and Operations Product and Channel Leads to meet site, channel, and product goals

Serve to develop, improve, and evaluate the critical thinking skills of the nurses, to achieve the highest quality and efficiency outcomes

Provide leadership, training, and coaching for nurses in: Clinical opportunity identification, intervention, and care plan development

Promotion of use of network providers, UnitedHealth Care Premium Providers, or other quality rated physicians

Internal partner referrals

Risk management and quality of care issues

Foster, create, and maintain a professional and respectful work environment to boost staff morale, satisfaction, retention, commitment, and engagement

Review business metrics, trend reports, utilization metrics, customer reports, and nurse and site performance metrics and present analysis and recommend action

Act as a consultant to the business leaders on clinical issues related to the business model, value levers, and strategy / product / program development

Participate in customer and consultant presentations, participate in audits, sales, retention efforts, and respond to questions related to clinical performance

“On call” for questions and issues related to utilization and medical expense reduction efforts for customers and consultants

Serve on project teams as a leader, participant, and/or consultant; Collaborate with internal business partners to promote value levers and other strategic initiatives

Work collaboratively with customers on mutually defined goals

Serve as a resource and a frequently requested clinical expert for outside prospects and customers by assisting the sales and account management teams with client meetings

Support community activities that enhance Community Relations and Reputation

As a Case Reviewer, Medical Directors:

Perform peer to peer discussions when indicated which promote optimal health and well-being of the individual

Through one-on-one discussions as well as Medical Director Value Case Reviews with nursing staff, stimulate critical thinking, assist in identification of clinical gaps, and coach staff on communication with providers and on care plan development

Direct coordination and management of complex care issues in conjunction with enrollees’ physicians and proposes care plans to prevent readmissions

Encourage the principles of “6C” call conduct, Inductive Call Anatomy, warm and engaging consumer interaction, call efficiency, good case management principles, and focus on measurable outcomes

In conjunction with Clinical Managers, work to improve the nurse knowledge base and management of cases through site leadership meetings, clinical teaching sessions, team meetings, case audits, nurse tools, and one-on-one case discussions

Adhere to medical director performance metrics and evaluations

Knowledge of admission, readmission data, and overall medical expense that would drive changes in focus at the case level

Alert UHC Medical Directors to provider issues of compliance with UHC protocols, over utilization, quality of care issues, and lack of adherence to EBM guidelines

Support quality reviews, inter-rater reliability sessions, regulatory requirements, and accreditation and certification efforts including performing audits and participating in quality clinical improvement studies

As a “Physician Liaison,” Medical Directors:

Interact with Regions, Markets, Customers, and other UHG Medical Directors, Sales, Account Management, Clinical Solutioning, Health Plan Medical Directors, Network Management, and OptumHealth partners to implement strategy implement products and programs, acquire and retain customers, and improve the quality and outcomes of the consumers navigating care delivered by the provider network and to improve relationships between the organizations

Attend Monthly Medical Expense Meetings by Region and assist with regionally based Affordability Initiatives with a focus on admission, readmission, and overall bed day management

Understand and act upon Condition Specific drivers including high cost claimants and consumers with a pattern of frequent utilization

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 with an active, unrestricted medical license in the state of Georgia

Current Board Certification in an ABMS or AOBMS specialty

3+ years of clinical practice experience

Excellent written and oral communication skills with customer facing experience

Excellent project management skills

Solid data analysis and interpretation skills; Ability to focus on key metrics

Proficiency with Microsoft Office applications

Within a commutable distance of the Atlanta office in order to be in the office a minimum 3 tim es per week

Preferred Qualifications:

Managed care experience, including UM, CM, Affordability / Cost savings initiatives, Quality Management experience

Board certification in Internal Medicine, Family Medicine, or Pediatrics

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.

Keywords:Medical Director, Atlanta, Georgia

Requisition Number 877843

Job Title National Accounts Medical Director Atlanta GA

Job Family Medical and Clinical Operations

Business Segment Enterprise Clinical Services

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-800-561-0861 and press or say 1 for Applicant to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

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.

Keywords: UnitedHealth Group Inc, Atlanta , National Accounts Medical Director Atlanta GA, Other , Atlanta, Georgia