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National Medical Director, Clinical Program Design & Evaluation - Telecommute
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 55345, Minnetonka, Minnesota, United States
Visa Sponsorship No

Job Description

Last Update: 4/23/21

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 a handful of patients each day, your work may affect millions for years to come. Join us. And start doing your life's best work.(sm)

This specialty line of service is charged with improving the affordability and quality of medical care across several related medical specialties. This small entrepreneurial team uses the company’s health care analytical tools, medical literature, clinical experience, and provider and member feedback to identify, design and implement clinical programs to lower cost, simplify healthcare delivery and improve quality and outcomes. The team is also accountable for post-deployment measurement of results. This position reports to the Senior Vice President of Value Creation for UnitedHealthcare.

This role will require a strategic and critical thinking mindset with the ability to handle multiple priorities as well as the ability to articulate and represent both UHC and Optum’s strategy to executive leaders across the enterprise and external stakeholders.

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

Primary Responsibilities:

  • The National Medical Director must have strong clinical and operational knowledge
  • Design, develop and evaluate clinical programs in collaboration with other internal teams and to oversee effective implementation in partnership with business partners
  • The National Medical Director partners closely with ACO/Organized Systems of Care leadership, Clinical Policy and Appeals/Grievances in decision-making, program management, and initiative implementation
  • Exhibit a provider and member-centered mindset by reflecting on all their needs and focusing on personalized care journeys when designing and evaluating programs. Consider Social Determinants of Health and leveraging community resources in program designs
  • Reviews metrics and processes of clinical programs and develops value-based criteria tied to provider contracts
  • Quantitative Analysis
  • The team often requires evaluation of data sets and/or development of research methods to evaluate a problem
  • The Medical Director works with experienced data analysts who perform the technical data retrieval and analysis
  • This person must be able to direct the analytics team as they work through hypothesis and problems and synthesize the results
  • Each project requires financial modeling to calculate the costs and returns of the programs
  • The National Medical Director works with the financial experts on the team to assure model assumptions are accurate
  • Qualitative analysis and strategic problem solving
  • Many of the issues presented to the team require qualitative approaches with minimal data available
  • The director should be comfortable making decisions using input from subjective sources
  • Presentation ability
  • The director is the face to external and internal customers and must possess the ability to speak clearly on complex problems
  • Audience size ranges from small teams to more than 1,000
  • Deliver Operational Excellence to make health care hassle-free for members while reducing administrative costs and provider administrative burden
  • Build and develop relationships across teams to ensure effective feedback loops and that deliverables are met
  • Advocates with leadership across the organization to create better alignment with business partners, business segments, and functional areas, thereby ensuring internal and external coordination and a unified approach to the market and associated constituents
  • Collaborates with the CMO, clinical, network and Optum leaders on top priorities and goals
  • Coordinates efforts of clinical, network, operations and HCE teams to support expansion of value-based programs delivered through our providers

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:

  • Board certification in Internal Medicine
  • Active Medical License and Board Certification
  • 15+ years of healthcare experience and 5+ years in a leadership role in a health system, clinical practice or a payer with an emphasis on Internal Medicine
  • 5+ years of Executive Management - The candidate can demonstrate this management experience as the leader of a complex project (health services research, for example), a clinical manager of a large clinician group or a business manager for an organization
  • 5+ years of experience with Public presentations - Professional presentations at academic meetings or business presentations are acceptable
  • 5+ years of clinical practice experience
  • Strong strategic, analytic and critical thinking skills with proven ability to use clinical, administrative and claims data to identify opportunities, inform program design and measure process, clinical and financial outcomes
  • Experience in design, implementation and oversight of utilization management and care management programs
  • Demonstrated ability to inform design, build and implementation of IT systems to support innovative clinical program – including workflow, data use and reporting requirements
  • Experience in overseeing the execution and metric-driven performance evaluation of vendors, operations teams and financial return on investment
  • Proven ability to drive, lead and communicate change effectively in a fast-paced environment and be adaptable within the changing environment
  • Ability to make strategic, operational and administrative decisions in response to emerging conditions and environmental circumstances
  • Ability to provide recommendations and insight regarding improvements to internal and external processes
  • Ability to manage programs and projects in a strategic and professional manner
  • Strong ability to communicate effectively and efficiently (both verbal and written) at multiple levels of large, complex organizations
  • Motivate. mentor and influence others at all levels within the organization
  • Solid organizational, management, administrative and human relations skills, and a style which exhibits emotional maturity, leadership, collaboration and teamwork
  • High level of proficiency with MS Word, Outlook, Excel, and Visio
  • Demonstrated ability in systems thinking and enterprise insight to solve complex business problem s and strong analytical skills with ability to drive transformational, consumer - centric change and manage long - term programs
  • Strong history of quickly building relationships, gaining credibility and partnering with business leaders. Must excel at building teams and collaborating across multiple distinct business groups
  • Ability and willingness to travel
  • 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 a similar UnitedHealth Group-approved symptom screener. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained.

Preferred Qualifications:

  • Advanced degree in Public Health, Analytics or Business

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

Colorado Residents Only: The salary range for Colorado residents is $348,100 to $433,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. The range and pay mix of base and bonus is variable based upon experience and metric [Register to View] of the date of this posting, in addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*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, Internal Medicine, Value Creation, Telecommute, Telecommuter, Telecommuting, Work from Home, Work at Home, 917049