Senior Medical Director, IPA (Optum Tri-State)
Company: National Medical Association
Location: Chappaqua
Posted on: August 5, 2022
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Job Description:
One of five regions in the Optum nationwide network, Optum
Tri-State comprises three large multispecialty groups, CareMount
Medical, ProHEALTH NY, and Riverside Medical Group. Optum Tri-State
brings patients local care, backed by national expertise. As a
premier provider of health care services, Optum Tri-State offers
services including primary care, urgent care, a diverse range of
specialty care, outpatient surgery, and imaging. The regions draws
on the knowledge of leading doctors and healthcare experts to help
1.6 million patients across 630 locations access high quality,
affordable healthcare within their community.
Job Summary: The Senior Medical Director for the IPA is responsible
for leading the IPA clinical model and developing / maintaining the
clinical relationships required for it to be successful. The role
will focus on building relationships, growing the network, and
accelerating the IPA's success in close partnership with
operational, network and finance leaders. The selected individual
must be:
A teacher, mentor, and a sounding board for the IPA providers.
A leader within the IPA as it develops and grows.
An advocate for the IPA doctors.
A champion of the Optum Care's Clinical Model and evidence-based
medicine.
A partner to other IPA leadership.
Essential Duties & Responsibilities include :
Aligning IPA physicians to the Optum Care mission and vision.
Physician education on the principles of value-based care with an
initial focus on Medicare Advantage (MA).
Develop and share clinical report cards, and partner with IPA
providers on action plans to achieve the quadruple aim.
Promoting the core tenants of the Optum Care Clinical Model which
include: Lead healthcare transformation as physicians
/clinicians.
Align incentive frameworks for providers.
Create an evolutionary roadmap to move providers along the change
continuum.
Support decisions at the point of care, where
Follow evidence-based pathways .
Measure our actions and our outcomes .
Remain agile and
Leverage best practices from our history of excellence to realize
the Optum Care clinical
Facilitate and coordinate wholistic and integrated person care
.
Remain safe, effective, patient-centered, timely, efficient and
equitable
Balance quality, cost, patient, and provider experience in pursuit
of the Quadruple Aim .
Required Qualifications:
Active Medical License/eligibility in the state of NY
Board Certified
7+ years with direct patient care preferably in primary care
5+ years medical leadership preferable as a medical director or CMO
leading care coordination
Excellent written and presentation communication skills
Familiarity with Medicare Advantage including HEDIS/Star and Risk
Adjustment
Familiarity with the principals of medical management including
Prior Authorization, Case Management, and Disease Management.
Strong EQ with proven influence management and negotiation
skills.
Proven ability to manage and drive team performance both in a
direct and matrixed environment.
Proven ability to quickly gain credibility, influence, and partner
with clinical and business leaders.
Excellent judgment, problem resolution, team building, negotiation,
conflict resolution, budgeting, decision-making, & experience
working under deadline pressure.
Ability to tell a story via WebEx /Teams.
Willingness to travel to IPA offices frequently/daily in assigned
territory.
Willingness to travel outside of immediate territory up to 25% of
the time (requiring overnight stays).
Preferred Qualifications: Familiarity with the NY healthcare
market, Primary Care physician, Healthcare payer experience.
Full COVID-19 vaccination is an essential requirement of this role.
CareMount will adhere to all federal, state and local regulations
as well as all client requirements and will obtain necessary proof
of vaccination prior to employment to ensure compliance.
All qualified applicants will receive consideration for employment
without regard to race, ethnicity, color, religion, sex, gender
identity, sexual orientation, national origin, disability, or
protected veteran status. CareMount is an EEO employer -
M/F/Veteran/Disability
Keywords: National Medical Association, Stamford , Senior Medical Director, IPA (Optum Tri-State), Healthcare , Chappaqua, Connecticut
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