Special Needs Program Medical Director - WellMed - San Antonio, TX (Ph

Company: Optum
Location: San Antonio
Posted on: September 17, 2020

Job Description:

Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered. We are looking for a Special Needs Program Medical Director to join our WellMed medical team in the San Antonio, TX office. The SNP Program Medical Director is the clinical half of the leadership dyad for the SNP Program. The person in this role does not perform Utilization Management reviews. This person works with the SNP Program VP to lead the SNP Program, they are specifically responsible for conducting weekly Patient Care Conferences with the PCPs from the markets for the SNP patients (currently there are 5-6 per week and in 2021 this will increase to 8-9 or perhaps 10 per week), and they also are responsible for ensuring the content of all assessments, program workflows, care plans, etc and meets all CMS requirements from clinical standpoint. Primary Responsibilities:

• Work to improve quality and promote evidence-based medicine
• Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement
• Covering both the SNP and Disease Management programs.
• The Medical Director is engaged in day-to-day management of the program, continuous development and refinement of assessments, and development of other clinical tools and processes.
• Directly oversees the Patient Care Conferences / Interdisciplinary Care Plan meetings for all of the SNP teams and supported markets. Providers clinical direction and training to SNP program staff, and consults with other medical directors and PCPs about SNP patients and processes.
• Develops and implements strategies to integrate the Disease Management program with the SNP program to achieve CMS Population Health objectives. Required Qualifications:
  • MD or DO degree
  • Active, unrestricted physician state license
  • Current board certification in ABMS or AOA specialty
  • 5+ years of clinical practice experience post residency
  • Strong understanding of and concurrence with evidence-based medicine (EBM) and managed care principles Preferred Qualifications:
    • Prior physician leadership experience
    • Hands-on utilization and/or quality management experience
    • Project management or active project participation experience
    • Substantial experience in using electronic clinical systems Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.SM WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
      OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.
      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
      Job Keywords: San Antonio, TX, Texas, Special Needs Medical Director, ABMS, AOA, practice Keyphrases: health administration jobs, medical director jobs, hospital administration jobs, hospital administrative jobs, healthcare administration jobs, administration jobs, healthcare administrator jobs, medical administration jobs, chief medical officer jobs, medical director position jobs, associate medical director jobs, medical administrative jobs, healthcare ceo jobs, medical ceo jobs, executive director jobs

Keywords: Optum, San Antonio , Special Needs Program Medical Director - WellMed - San Antonio, TX (Ph, Executive , San Antonio, Texas