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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Medical and Clinical Operations

Country:

United States

Postal Code:

37024

Approximate Salary:

Not Specified

Position Type:

Full Time

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Medical Director - UnitedHealth Care Community Plan - TennCare

UHG - Brentwood, Tennessee

Posted: 09/13/2018

You're looking for something bigger for your career. How about inventing the future of healthcare? UnitedHealthcare is offering an innovative new standard for care management. We're pushing ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. As an Associate Medical Director you will use your talents to take our already exceptional service and innovation to the next level. You will lead a team of world-class professionals who are removing barriers to better health with every new idea. Ready for a new path? Join us and start doing your life's best work.(sm)

 

What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the healthcare system. Be a leader that is shaping our incredible team culture and be a part of a clinical and business collaboration that is learning and evolving every day.

 

The Associate Medical Director has accountability for developing and supporting our population health program, including the management of special populations and programs, supporting members with special medical and behavioral needs, intellectual disability, and long term services. The Associate Medical Director will be responsible for assigned health plan initiatives on affordability, quality and clinical excellence, and growth in populations mentioned above and the programs that support them. Depending on the level of experience, interest and expertise, programs these could include children’s EPSDT programs, maternity programs for high risk pregnant members, those member who are dually eligible for Medicaid and Medicare, members in the TennCare Long Term Services and Supports or Employee Community First Choices. There will be shared responsibility of improving quality, affordability, and working with and developing an integrated services model that meets the needs of our population.

 

Primary Responsibilities:

  • Collaborates with the market lead Chief Medical Officer and various program directors, clinical quality , population health , operations , compliance and other market staff to implement programs to support and meet state and national clinical operations goals
  • Provides support and guidance to the community care teams of care coordinators, care managers, behavioral specialists, community health workers, and other clinical staff
  • Works toward fully integrated clinical model working with Behavioral Health and Choices clinical management, and leads coordination of clinical activity with other state programs such as the DIDD program for TennCare member with intellectual and developmental disability
  • Reports to Health plan Chief Medical Officer with accountability to various clinical program leaders
  • Leadership role in local clinical operations and initiatives
  • Manages external physician relationships as needed, acts as community ambassador, and works in developing new business opportunities as required
  • Participates in and may lead quality evaluations, committees and subcommittees, and peer review activity
  • Represents the health plan in various TennCare activities to include the state payment reform initiative and various other programs and meetings
  • Responsible for managing/monitoring the financial results of Care Management/Health Services interventions and initiatives to ensure that utilization goals are achieved; collaborating with Care Management/Health Services/Behavioral Health as necessary to maintain focus on achieving targets
  • Develops new ideas for affordability initiatives in the population and drive their implementation when selected
  • Supports local market data, sharing activities which include: reviewing completed data analysis and establishing a process for sharing data with facilities, physicians, and other providers as needed
  • Responsible for complex case review with clinical staff, care managers, and IDD care coordinators
  • Delivers the clinical value proposition in support of the sales and or growth activities of the Health Plan
  • Promotes positive relations with State/local regulatory authorities and Medical Societies
  • Active participation in support of Joint Operating, QM, and PAS Committees
  • Coordinates care with the local integrated behavioral health teams

Required Qualifications:

  • MD or DO with an active, unrestricted Tennessee license
  • Board Certified in an ABMS or AOBMS specialty- pediatrics, medicine-pediatrics, family or internal medicine with fellowship, additional training, and/or experience in patients with special needs
  • Intermediate or higher level of proficiency with managed care and/or population health

UnitedHealthcare Community & State is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US healthcare system. If you're ready to help make healthcare work better for more people, you can make a historic impact on the future of healthcare at UnitedHealthcare Community & State and the health of Tennesseans. We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach. This enables us to break down barriers, which makes healthcare easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for people all over our state of Tennessee and country.

 

 

Diversity creates a healthier atmosphere: 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: Associate Medical Director, healthcare, Brentwood, Memphis, Knoxville, Tennessee, TN

 

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