30+ Days ago
1 day ago
We at NAMM, a part of OptumCare, deliver a clearly differentiated level of outcome and service adherence. Come join our team and add to our bench strength as we execute on managed care 2.0 bringing together revenue optimization, appropriate utilization, unit cost management and strategic acquisitions. Quality care saves money without exception. North American Medical Management, California, Inc. (NAMM) develops and manages clinician networks, offering a full range of services to assist physicians and other clinicians in their managed care and business operations. For over 17 years, NAMM has been an innovator in health care with a track record for quality, financial stability, extraordinary services and superior electronic capabilities.
This immediate leadership opportunity will interact with Physicians and IPA staff to ensure that patient needs responsible for many Medical Management functions that including but not limited to provider relations, Utilization Management and Quality Management functions. Management, oversight and development for major programs and functional areas within an IPA setting including medical policy review and development, patient centered medical home oversight, population management, and reporting functions. Work with physicians and other providers, especially PCMH practices, to improve the quality, affordability, and member satisfaction in order to achieve the Quadruple Aim.
Possess a current and unrestricted MD or DO license in California
Board certification in chosen specialty
Minimum 2+ years of experience working as a Medical Director in a managed care setting with minimum 2+ years of experience in utilization management, utilization review and prior authorization.
Minimum 2+ years of experience interacting with both group and IPA Physicians including experience with inpatient / hospitalist management.
Experience supervising Advanced Practice Clinicians
Prior experience working with clinical information technology systems
Comfortable presenting 1:1 and in group setting
Excellent communication skills
Diversity creates a healthier atmosphere: Optum and its affiliated medical practices are 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. Optum and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.