Job Summary
Job Description
Risk Adjustment Medical Director – Optum New Mexico
Overview of Position:
Responsible for administration and oversight of the medical and clinical activities of employed and contracted providers as well as various operations functions within assigned market(s) to ensure appropriate practices related to risk adjustment activities, HEDIS measures, and any appropriate gaps in care. The Medical Director works collaboratively with all facets of the business and business leadership including Risk Adjustment, Clinical Education team, other Medical Directors and leaders, coding department, physicians, site administrators and operations, to educate and improve accurate coding and documentation skills, leading to a more complete patient record.
The Risk Adjustment Medical Director is responsible to lead efforts to improve risk adjustment programs including accurate documentation and coding and to be accountable for those improvements and outcomes.
Experience:
- CMS-HCC operations
- Experience with Risk Adjustment/ STARS/ HEDIS
- Minimum 3 years of practicing medicine
- Over 3 years of supervisory experience
- Knowledge of the coding/billing/documentation
Albuquerque:
- Top 10 for America’s Best Cities for Foodies, Travel
- Top Big Best Cities for Active Families, Outdoor Magazine
- Top City with the Cleanest Air in America, Thrillist
- Top 5 for “Secretly Cool Cities, Huffington Post
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Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. 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. Here you’ll find incredible ideas in one incredible company and a singular opportunity to do your life's best work.(SM)