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Opportunities with Optum in the Tri-State region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind 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 HCC coding 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 located in Chappaqua, NY, you will have the flexibility to work remotely*, as well as work in the office as you take on some tough challenges. 25 percent travel required.

Primary Responsibilities:

• Clinical risk 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 HCC Coding

• Communication on new suspected conditions

• 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

• 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

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:

• Current unrestricted license to practice medicine and actively providing direct patient care in (adult medicine) M.D. or D.O. with board certification in a medical specialty including Internal Medicine or Family Medicine

• Board certified in Internal Medicine, Critical Care or another specialty with hospital-based practice

• 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

• Proven ability to influence without authority

• Proven ability to successfully operate in a dynamic and changing environment

• Proven ability to implement complex programs and monitor implementation and necessary modifications

• Proven ability to manage multiple priorities and deadlines in an expedient and decisive manner

• Proven innovative thought process and problem-solving skills

• Proven solid presentation and persuasion skills; ability to speak clearly and lead discussions with senior executives and large groups

• Proven solid verbal and written communication skills

Preferred Qualifications:

• Solid baseline knowledge of Risk Adjustment, and other Pay for Performance Programs

• Proven 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

• Proven 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

New York Residents Only: The 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.

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.