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The Clinical Medical Director (CMD) is responsible for implementation of The Group’s long and short term strategic healthcare initiatives, designing and implementing viable clinical services and programs to deliver quality healthcare to our community. Approved strategic initiatives will be designed to keep the organization in the forefront of the changing national healthcare industry as well as demonstrating clinical leadership in the local market. The CMD will serve as a valuable clinical resource for information and consultation on issues related to clinical services, medical policy, practice guidelines and clinical review of technology. Responsible for providing Utilization Management clinical reviews as needed. Ensure all established clinical guidelines are adhered to. Other accountabilities will be implementing continuous quality improvement and educational programs for Providers, developing procedures/guidelines for managing the clinical and financial risk of coordinated care, overseeing quality accreditation initiatives and participating in the development of quality and productivity incentive programs for Providers. Adheres to policies, procedures and regulations to ensure compliance and patient safety. Participation in Compliance and other important training is a condition of employment.

DIRECTOR AND MANAGER COMPETENCIES:

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  Aligning Performance for Success: Focuses and guides others in accomplishing work objectives.
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  Gaining Commitment: Uses appropriate interpersonal styles and techniques to gain acceptance of ideas or plans; modifies one’s own behavior to accommodate tasks, situations, and individuals involved.
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  Selecting Talent: Evaluates and selects internal and external talent to ensure the best match between the individual and the work requirements.
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  Strategic Decision-Making: Obtains information and identifies key issues and relationships relevant to achieving a long-range goal or vision; commits to a course of action to accomplish a long-range goal or vision after developing alternatives based on logical assumptions, facts, available resources, constraints, and organizational values.
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  Patient Relations: Meets patient and patient family needs; takes responsibility for a patient’s safety, satisfaction, and clinical outcomes; uses appropriate interpersonal techniques to resolve difficult patient situations and regain patient confidence.
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  Business Acumen: Uses economic, financial, market, and industry data to understand and improve clinic business results; uses one’s understanding of major business functions, industry trends, and The Group’s position to contribute to effective business strategies and tactics.
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  Developing Others: Plans and supports the development of individuals’ skills and abilities so that they can fulfill current or future job/role responsibilities more effectively.
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  Leadership Disposition: Demonstrates the traits, inclinations, and dispositions that characterize successful leaders; exhibits behavior styles that meet the demands of the leader role.
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  Planning and Organizing: Establishes courses of action for self and others to ensure that work is completed efficiently.

ESSENTIAL FUNCTIONS:

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  Provides leadership to the Group in the design and implementation of strategic healthcare initiatives such managed care services within the community, the implementation of new clinical services within the Group, and the redesign of current clinical and professional services.
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  Researches and recommends new healthcare service opportunities, keeping the Group ahead of changing national healthcare requirements and/or legislation, as well as anticipating and responding to the needs of the local community for healthcare.
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  Supports the Chief Operating Officer (COO) in the development and implementation of managed care operational processes as necessary.
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  Serves as an internal consultant to the Group in the development of managed care risk contracts and to physicians in the successful case management of patients under various managed are risk arrangements.
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  Supports the COO in the development and implementation of managed care operational processes as necessary.
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  Assists in the presentation of reports on managed care, health and quality improvement issues, as determined by the President.
  
• Build, grow, and maintain relationships between The Group and hospitals, health plans, and other medical organizations as necessary.
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  Performs other duties as assigned.
  

Required Qualifications:

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  Two (2) years’ experience at senior leadership level in medical group or network; five (5) years’ experience as a practicing physician preferably in a medical group
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  Current MD/DO medical license in the state of New Mexico
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  Board Certified in Specialty or Primary Care, or in the process of obtaining certification unless granted an exemption by Credentialing Committee and/or Board of Governors
  
• New Mexico Pharmacy/DEA Registration if applicable to practice
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  Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

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  Master’s Degree in related field
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  Experience in both fee-for-service and managed care operations
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  Excellent communication skills, both verbal and written
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  Ability to comfortably use Microsoft Word, Excel, and PowerPoint
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  Thorough understanding of medical group business models and clinical processes
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  Excellent understanding of medical group financial concepts, including revenue cycle, physician compensation models, and preferably including managed care financial concepts (capitation, IBNR, MLR)

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

About OptumCare:

At OptumCare, we’ve found that putting clinicians at the center of care is the best way to improve lives. Our physician-led organization is one of the most dynamic and progressive health care organizations in the world, serving over 17 million people through more than 45,000 aligned physicians and 9,000 advanced practice clinicians. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Learn more at www.workatoptum.com.

Would you thrive with OptumCare?

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  Do you practice evidence-based medicine?
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  Are you seeking a practice focused on patient-centered quality care, not volume?
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  Are you a team player - comfortable delegating and empowering teams?
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  Are you constantly seeking better ways to do things?
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  Do you want to be part of something better?

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.