For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.
Optum’s Whole Health Solutions team enables value-based care across the health care system by developing and deploying innovative, integrated, person-centered solutions that improve access, reduce cost and simplify experiences, ultimately leading to better health outcomes.
The Optum Whole Health Solutions (WHS) Sr Medical Director Medical Director for Value Based Care will lead Optum’s Clinical Sciences Institute (CSI), a multi-disciplinary team that manages the clinical evaluation process for Optum's nationally recognized Centers of Excellence (COE) in the areas of organ transplantation, congenital heart disease, bariatric surgery, infertility, and orthopedic procedures. As Optum Health Solutions expands the scope of CSI into new innovative clinical areas to guide more individuals to highest quality care, this newly created role requires an innovative, hands-on, action-oriented clinical leader who can build upon the existing strong foundation to drive transformational change in the care for complex and/or rare conditions. This is an exciting opportunity for a clinical leader who can think strategically while at the same time staying closely connected to the details necessary to drive excellence in a team focused on leveraging data and analytics to extract meaningful clinical insights for programs that impact the lives of millions of individuals in need of highly specialized medical care.
You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Implement new innovative methodologies for evaluating the quality of care at facilities or practices under consideration for a COE or other value-based care program.
- Evaluate clinical and other data (e.g., quality metrics, claims & health record data, utilization data) to identify opportunities for improvement of clinical care through COE criteria, network design, or value-based care models.
- Provide thought leadership on opportunities for innovation and enhancement of value based programs across Optum and UnitedHealth Group as well as to clients and external stakeholders.
- Present Optum’s strategy and programs to deliver value-based care to small and large audiences of internal and external stakeholders, including clients, provider groups, health care systems, professional conferences and thought leaders.
- Collaborate with operational and business partners to develop novel contracting strategies to improve the quality and value of care for members served by Optum Health Solutions.
- Lead Optum Health Solutions Clinical Sciences Institute, a multi-disciplinary team that manages the clinical evaluation process for Optum's nationally recognized Centers of Excellence (COE) in the areas of organ transplantation, congenital heart disease, bariatric surgery, infertility, and orthopedic procedures.
- Provide the clinical leadership to expand the scope of the Clinical Sciences Institute to encompass new clinical areas, such as gene therapy, neuromuscular disorders, rare diseases.
- Manage the team that develops clinical guidelines used to determine the clinical appropriateness of care in Optum programs and ensure that they are consistent with evidence-based medicine standards.
- Monitor program outcomes to ensure compliance, quality, affordability, and NPS are achieved/exceeded.
At Optum, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.
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 with an active, unrestricted medical license.
- Current ABMS or AOBS Board Certification in Primary Care.
- 3+ years clinical practice experience post residency.
- 3+ years of leadership experience in managing a team or in a matrix environment.
- 3+ years of demonstrated accomplishments in population health/care management and consumer experience.
- Experience working in a health plan.
- Demonstrated excellence with verbal and written presentations to clients and at conferences to meet client needs in partnership with Product and Sales Teams.
- Proven analytic and critical thinking skills with proven ability to use clinical, administrative and claims data to identify opportunities and measure process, clinical and financial outcomes.
- Willing to travel 25% as needed.
Preferred Qualifications:
- Master’s degree in health or business-related field (MBA, MPH, MMM, etc.).
- Experience developing clinical guidelines or health plan coverage policies.
- Experience with Commercial plans and/or Medicare/Medicaid.
- Proven outstanding written and verbal communication.
- Proven solid consensus builder and effective influencer and motivator of teams, staff, providers and ability to lead through influence in a matrixed organization.
- Proven solid strategic thinking with business acumen and ability to align clinical related strategies and recommendations with business objectives.
- Demonstrated ability to lean in and problem solve.
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
The salary range for this role is $343,500 to $516,500 annually based on full-time employment. Salary Range is defined as total cash compensation at target. The actual range and pay mix of base and bonus is variable based upon experience and metric achievement. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.