Medical Director

Optum / Orlando, Florida

Do what you love with people you love.

Life Changing Work

Want to bring your passion to work and your practice to life? Looking for a team that looks out for you? Want to make a real difference in the lives you touch?

LOOK NO FURTHER.

We’re passionate about patients. We’re leading the state of Florida towards better healthcare practices. And we’re looking for amazing doctors like you.

OVERVIEW OF POSITION:

The Medical Director reports to the CMO and will provide clinical and administrative support to Primary Care Providers, Hospitalists, and Mid-Level Practitioners, including utilization and quality management, data analysis and problem solving functions in a largely Medicare Advantage environment.

ESSENTIAL FUNCTIONS:

• Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with each and every internal and external customer.
• Represents the Company in a professional manner, following all Company policies and procedures.
• Uses, protects, and discloses patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Performs utilization management and dialogs with physicians as necessary to promote cost effective and quality outcomes.
• Assists physicians with pharmacy management issues and complex medical management issues.
• Works with nurses performing high-risk case management and disease management.
• Mentors physicians with regard to their clinical, managed care and personal concerns.
• Helps to manage change.
• Participates in committees to set medical management policies
• Analyzes data, performs variance analysis, prepares and implements medical action plans to improve performance at centers and overall.
• Analyzes practice patterns (data, profiling) and implements changes.
• Analyzes and improves quality outcomes.
• Works with contracting on network matters as they arise and interacts with specialty network to resolve differences.
• Assists with physician recruitment as well as discipline.
• Works with operations to ensure smooth running health centers in such matters as physician access and availability and helps in identifying root cause issues that affect care outcomes.
• Participates in peer review and risk management activities.
• Valid Florida driver’s license, insurance and vehicle for work-related travel.
• Performs other duties as required.

EDUCATION:

• MD/DO degree from accredited medical school and residency in Family Medicine or Internal Medicine.
• MBA/MHA helpful but not required.
• Current and Unrestricted DEA certificate.
• Board certified in Internal Medicine or Family Practice.
• Florida license or ability to obtain one within 6 months.

EXPERIENCE:

• Minimum of 5 years practice experience preferred.
• Prior experience as a medical director preferred in either a group practice, hospital or health plan. Utilization Management experience preferred.

KNOWLEDGE, SKILLS, ABILITIES:

• Ability to travel locally between multiple locations in Tampa and Orlando.
• Ability to become credentialed by health plans.
• Strong analytical/data analysis skills and comfort developing and implementing medical action plans.
• Strong leadership, communication, written and negotiation skills required.
• Ability to manage change essential. Must be able to focus on priorities independently.
• Comfort with conflict management.
• Supervisory skills, including clinical mentoring.
• Ability to influence team members without direct reporting relationships.
• Comfort with basic computer skills.
• Ability to read, write, speak and understand the English language fluently and document clearly in the medical record.
• Ability to read, write, speak and understand the Spanish language is a plus.