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Medical Director, Physical, Behavioral Health - Adult - Telecommute in New York, NY
Optum
Eden Prairie, Minnesota, United States

Job Summary

Occupation Physician
Specialty Medical Director
Degree Required MD/DO
Position Type Permanent/Full-Time
Work Environment Hospital Clinic/Private Practice
Location 10002, New York, New York, United States
Visa Sponsorship No
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Job Description

Last Update: 3/22/21
UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

If you are located in the New York, NY area, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:
  • Oversee the integration of care of General Medicine (adult) members with the Health and Recovery (HARP) programs
  • Provide expertise to the Behavioral health/substance abuse/SMI programs on pharmacy benefits and health risks of psychotropic drugs
  • Working with the Senior Leadership Team and Behavioral Health lead, provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement
  • Responsible for working with the Senior Leadership Team on execution of affordability and clinical quality activities at FQHC's, Accountable care Organizations, Health Homes and other physician/hospital practice groups
  • Support initiatives that enhance quality throughout our network in order to reach quality goals
  • Provide oversight and management of the HEDIS data collection process and other processes that drive Health Plan accreditation activities
  • Support the Health Plans Care Management activities (Whole Person Care, Healthy First Steps programs) and continuum of care rounds. Lead a team of in-house care managers and community health workers
  • Support the teams providing member fair hearings, prior authorizations, network programs, affordability initiatives and Quality programs. Focus is on integration (parity) of Behavioral and Physical Health for members in the HARP program
  • Deliver the clinical value proposition in support of the sales and growth activities of the Health Plan in Medicaid, Essential Plan, HARP and Medicaid/Medicare dual eligible members
  • Interact with State and other regulators to provide data, conduct planning and resolve issues as required to maintain excellent relationships with auditors and regulators
  • Responsible for identifying opportunities through participation in local Medical Committees, external committees and joint operating committees with providers and hospitals throughout New York

Success in this technology-heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production-driven setting.

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 degree (adult medical specialties)
  • Active, unrestricted physician state license in New York
  • Current board certification in Internal Medicine, Family Practice or General Medicine - ABMS or AOA specialty
  • 5+ years of clinical practice experience post residency
  • Strong understanding of and concurrence with evidence-based medicine (EBM), Medicaid and managed care principles as well as Physical/Behavioral Health clinical integration
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:
  • Hands-on utilization and/or quality management experience
  • Project management or active project participation experience
  • Substantial experience in using electronic clinical systems
  • Familiarity with data analytics in Healthcare

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place 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.

Job Keywords: Medical Director, Physical, Behavioral Health, Adult, Physician Executive, Clinician, Clinical Quality, HEDIS, Value Based, Doctor, Appeals, PMPM, Sales And Growth Activities, Work From Home Must Commute To NY When Needed, New York, NY