Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere.

As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. This life-changing work adds a layer of support to improve access to care.

We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together.

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 at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 6 industry leader.

The Optum Home & Community Market Medical Director is a member of the Market’s Senior Leadership Team (SLT) for Senior Community Care (SCC). They will work with the SLT to develop and drive the business strategy, growth, and clinical operations and help to ensure that the highest level of quality care is being delivered to the residents of our partner nursing homes. This individual will work collaboratively with the site’s advanced practice clinicians (APCs), and will serve as a clinical resource when needed. This position is recognized as the clinical ‘face of the business’ related to the clinical and business communities. The Medical Director will interface with contracted nursing homes and their attending physicians across the market. We are looking for someone to cover our operation in Indiana, Ohio, Illinois and Kentucky.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Achieve sustainable, profitable growth via new business development and growth

• Promote the clinical and financial value propositions to new business and current partner stakeholders to achieve growth goals

• Coordinate and facilitate the orientation of all new Primary Care Physicians (PCPs) to the model

• Routinely meet with currently collaborating PCPs

• Collaborate with Business Development team to identify potential Skilled Nursing Facilities (SNFs) and Provider Groups with new membership opportunities

• Engage and speak with state and local organizations, Long Term Care (LTC) industry associations, medical society memberships, etc., regarding the value and quality outcomes of the Optum models of care

• Develop and sustain solid relationships with other medical directors and health care system leaders in market territory

• Actively engage NP / PA clinical staff with didactic, written and 1:1 education on geriatric syndromes, chronic illness, SNF regulations, and end of life / palliative care

• Assist in quality of care concern case reviews and corrective action plans (CAPs)

• Develop and revise clinical practice standards and procedures

• Fulfill requirements for Special Needs Plan (SNP) Model of Care, State, and Federal Regulations

• Assume a leadership role for achievement of targets for market or contract specific STAR and gap closures; HEDIS measures; and Quality Improvement Programs

• Lead market review and develop education and operational plans to address pharmacy, acute hospitalization, skilled SNF services, DME, and medical expense management

• Lead the medical discussion for the weekly calls on avoidable hospital transfers

• Provide leadership accountability for ensuring accuracy of all documentation and coding

• Educate NP / PA staff in use of coding tools and documentation requirement

• Commute to main office, for meetings, approximately every other month, and upon request

• Assume less than 25% day travel within the market territory as noted above.

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:

• DO or MD with a full, active and unrestricted license to practice medicine in the State(s) of the market

• AOA or ABMS Board Certified in: Internal Medicine, Family Medicine, Geriatrics and/or Hospice/Palliative Care

• 5+ years of experience working with geriatric and/or long-term care population

• Experience working with and educating APCs: Nurse Practitioners (NPs) and/or Physician Assistants (PAs)

Preferred Qualifications :

• Certification by the American Board of Post-Acute and Long Term Care (ABPLM)

• Health care management / leadership experience

• CMS, Medicare Advantage, Special Needs Plans (SNP) Rules and Regulations

• HCC and Risk Adjusted reimbursement methodology

• Inpatient / SNF utilization metrics and bed day management

• Financial Reports: Revenue; Expenses; Contribution Margin; Budgeting & Forecasting; BCR; IO

• Working knowledge of EMR structures

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The hourly/salary range for this role is $286,104 to $397,743 annually. 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 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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.