Medical Director for Specialty Management @ Optum

Medical Director for Specialty Management @ Optum

Link to Job Application Page - Click here to visit Optum Career Site

Optum is a physician-led, close-knit team that has been long-respected in Southern California. We are passionate about patients. We are leading the state of California toward better healthcare practices. And we are looking for amazing clinical leaders like you.We have immediate opportunity for a Medical Director - Specialty Management to join our Orange County regional leadership team.

Overview: Responsible for multiple medical management functions including, but not limited to, management of specialist network, utilization management and quality management functions as well provide specialist clinical care at various sites in designated region. Collaborate with physicians and other providers to improve the quality care, affordability, and member satisfaction. Position will be approximately eighty percent medical management and twenty percent clinical care.

Primary Responsibilities

• Provide medical and operational guidance at outpatient specialty clinics including, but not limited to, managing quality, clinical metrics in addition to practicing as a Specialist (position is approximately fifty percent patient care).

• Drive development and implementation of specialist guidelines to enable consistency and greater effectiveness across the employed and contracted specialist network to build a One Optum community.

• Provide medical leadership and physician advice to the quality management area with respect to quality improvement studies, quality improvement committees, and primary care assessments (both office-site assessments and medical record document reviews).

• Provide medical expertise for traditional utilization management services and resources for outpatient medical, surgical, and pharmacy activity.

• Educate and communicate with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization, and effective resource management.

• Participate and may facilitate conformance to DHCS, CMS, DMHC, NCQA and other regulatory requirements

We offer a competitive salary, bonus plan and comprehensive benefit package including medical malpractice coverage, CME time and dollars, medical, dental and vision benefits, company paid life insurance, available supplemental insurance plans and 401K plan.