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National Medical Director Clinical Affordability (Telecommute)

UnitedHealth Group

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745926 National Medical Director Clinical Affordability Telecommute

National Medical Director Clinical Affordability (Telecommute) (745926)

Position Description

Medical Director careers at UnitedHealth Group are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the health care industry forward. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Join us. And start doing your life's best work.(sm)


The National Medical Director Clinical Affordability will report to the Chief Clinical Performance Officer for OptumCare and will be responsible for providing strategic direction, development and execution of a model of care focused on affordability.  This model includes UM / CM / DM, Transitions, Social and End of Life Care programs across all line of business, in diverse local markets, while preserving local market uniqueness and relationships.



The role itself must be a deep subject matter expert who can drive execution and change through collaboration and relationships. The Medical Director will provide long - term planning and oversight assuring activities are appropriately integrated into strategic direction, as well as the mission and values of the company.   This also involves selection and expansion of best practices while simultaneously striving for standardization and driving performance. 



This role will be partnered with a senior Medical Director and together with the help of the Portfolio Management team, will drive results. It will have no direct reports but may provide indirect work direction & guidance to other employees.

Given the complex nature of OptumCare, the ability to achieve these goals through a combination of direct and indirect influence will be critical.



Primary Responsibilities:

  • Lead through influence the Medical Leadership of varying businesses and their corresponding hierarchies (totaling approximately 12) across the country with expectations to grow over time

  • Direct the delivery of extremely complex business solutions within the enterprise Clinical Performance team and across multiple cross - matrixed teams

  • Provide leadership and direction in lowering the cost of care 

  • Take full accountability for patient and financial results

  • Assist in driving results with the Care Delivery organizations

  • Coordinate inter - Care Delivery organization discussions to leverage knowledge and learning

  • Interface with Healthcare Economics teams to size, review, and prioritize opportunities

  • Analyze and convey a deep understanding of data insights and use of standard benchmarks

  • Support overall regional and corporate goals to ensure continued growth and profitability

  • Participate in new market  expansions

  • Align with national standards and medical expectations as they relate to care management

Required Qualifications: 

  • M.D Board Certified in a post graduate clinical specialty; internal medicine, geriatrician, or Primary Care preferred; Un - restricted Licensed to practice Medicine in any state

  • 10+ years’ experience in the healthcare industry in an medical administrative role (work in the payer and provider fields both a plus)

  • 10+ years’ experience working in UM/DM/CM or related fields  

  • Familiarity with the following is key :

      • Medicare, Commercial and Medicaid benchmark and trend data; Medicare regulations with respect to inpatient and SNF management.  Cost of care metrics; Payment methodologies including fee for service (CMS-1500, CMS UB 04);Broad and comprehensive knowledge of the care of patients in outpatient care settings including but not limited to Clinics, Ambulatory Surgery, Procedure labs, etc.  Health plan finance reporting; care models and staffing  models

      • Good understanding of managed care systems, quality improvement and risk management

  • Proven ability to develop plans and strategy with technology organizations

  • Demonstrated ability to work in a highly matrixed organization

  • Knowledgeable on Delegation in managed care and on how to establish  newly delegated entities

  • Strong interpersonal skills and ability to build relationships

  • Excellent presentation, writing, and negotiation skills

  • Outstanding organizational skills

  • Strong consulting skills

  • Ability to influence others

  • Proven ability to work with people at multiple levels of the organization, multiple functions of an organization, and multiple locations

  • Demonstrated leadership skills

  • Willingness to travel up to 50%, or as determined by business need


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


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.



Keywords: Physician, Managed Care, Telecommute, Technology, Provider, WFH


Job Details

  • Contest Number745926
  • Job TitleNational Medical Director Clinical Affordability (Telecommute)
  • Job FamilyMedical and Clinical Operations
  • Business SegmentOptumCare

Job Location Information

  • MN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job Level
  • ShiftDay Job
  • TravelYes, 50 % of the Time
  • Telecommuter PositionYes
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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