Associate Medical Director, Risk Education - Hybrid

Optum NY, (formerly Optum Tri-State NY) is seeking a Associate Medical Director, Risk Education to join our team in Queensbury, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live.

As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The Optum Health East region is seeking an experienced clinician to support our Medicare risk adjustment education efforts. Working with the Medical Director for Risk Adjustment and the Chief Clinical and Value Officer in Optum East, this key physician will provide expertise in risk adjustment and clinical documentation education for the markets in the Optum Health East region. This role will be part of a team focused on supporting clinicians to provide the highest level of care possible.

This is a role that partners with external physicians and leaders and requires collaboration and the ability to build relationships across all levels of the organization to ensure goals are met. This physician will be comfortable interacting daily with clinicians of all levels, as well as frontline clinicians and operational staff.

If you are willing to 2-3 days on site to various locations, you will have the flexibility to work remotely* as you take on some tough challenges. This is a hybrid role.

Primary Responsibilities:

• * Clinical risk adjustment and documentation education
  
  
  
  • Provides ongoing, targeted mentoring and education to physicians and APCs on appropriate diagnosis coding and supporting documentation including
    
    
    
    • Risk education sessions and materials for clinicians in both primary care and specialties
    • Organization-wide training on changes or updates to risk adjustment models
    • Programs designed to ensure all diagnosed conditions and appropriate codes are supported by documentation in the patient chart
    
    
    
    
  • Educates physicians and APCs to ensure appropriate practices related to risk adjustment activities, HEDIS measures and gaps in care throughout the market.
  • Works with the Medical Director, Risk Adjustment to establish a competency baseline for provider performance. Monitor the progress of providers receiving mentoring and develop tailored strategies to improve performance.
  • Informs physicians and APCs around year-over-year changes to the Medicare risk adjustment to provide thought leadership and assists in carrying out recommended actions.
  • Provides clinical support for embedded nurse practitioner programs.
  • Supports clinical documentation education program alignment and prioritization across the region.
  
  
  
  
• * Partnership with operational leaders:
  
  
  
  • Builds/maintains/manages market stakeholder relationships across multiple layers and functions.
  • Monitor wrap around programs for effectiveness and assist in coordination, adoption and resolving barriers as needed to achieve outcomes.
  • Participates in regulatory and accreditation activities, as applicable
  
  
  
  
• * Emotional maturity for effective change management
  
  
  
  • Establish solid and lasting, trust-based relationships within team and external partners
  • Foster exemplary teamwork and strengthen a culture of continuous improvement and accountability
  • Take initiative and self-start attitude to approach problems with energy and passion
  • Demonstrate preference for working in a tight-knit team environment with diverse professional groups
  • Utilize a solid fact base to influence and lead physicians and support staff to implement change programs
  
  
  
  
• * Ensures overall program success
  
  
  
  • Reducing barriers for program implementation teams, including anticipating and responding to potential roadblocks
  • Active problem solving to meet evolving challenges in a highly dynamic environment
  • Distributing performance management reporting to market leaders and synthesizing information for adjustment and optimization
  • Conducts deep dive program reviews with relevant internal and/or external stakeholders to identify opportunities for continuous improvement
  • Works collaboratively to inform new, innovative, or complimentary program ideas at scale
  • Collaborates with other team members to align on meeting expectations and material preparation
  • Interacts with senior management by providing thoughtful analysis on key decision points to drive initiatives forward
  
  
  
  
• * Local travel to provider locations as needed.
• * Other duties as assigned and participate in early morning and evening meetings as needed

Optum NY/NJ was formed in 2022 by bringing together Riverside Medical Group, CareMount Medical and ProHealth Care. The regional alignment combines resources and services across the care continuum - from preventative medicine to diagnostics to treatment and beyond across New York, New Jersey, and Southern Connecticut. As a Patient Centered Medical Home, Optum NY/NJ can provide patient-focused medical care to the entire family. 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. Together, we're making health care work better for everyone.

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:

• M.D. or D.O. degree
• Current unrestricted license to practice medicine
• Board certified in Family Medicine, or Internal Medicine
• 5+ years of clinical experience
• Direct experience with Risk Adjustment diagnosis coding as a provider
• Solid knowledge of electronic health records, including experience in chart review
• Demonstrated ability to influence without authority
• Demonstrated ability to successfully operate in a dynamic and changing environment
• Demonstrated ability to implement complex programs and monitor implementation and necessary modifications
• Demonstrated ability to manage multiple priorities and deadlines in an expedient and decisive manner
• Proven innovative thought process and problem-solving skills
• Demonstrated solid presentation skills; ability to achieve change management in a matrixed environment; ability to speak clearly and lead discussions with senior executives and large groups
• Demonstrated solid verbal and written communication skills
• Willing or ability to continue to see primary care patients

Preferred Qualifications:

• Proven solid baseline knowledge of Risk Adjustment, and other Pay for Performance Programs
• Demonstrated ability to understand and navigate the organization's culture; able to think both strategically and tactically; respected by peers; maintains competency and enhances professional growth and development through continuing education; general understanding of disparate systems and integration/information flow
• Demonstrated ability to form solid relationships with peers in practice, and leadership
• Proven credibility among the medical staff as a provider
• Proven belief in and enthusiasm for the role of Pay for Value to improve the delivery of care
• Proven effective listening and negotiating skills and patience

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

The salary range for this role is $104,500 to $156,000 annually based on full-time employment. 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.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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