Part-Time Medical Director-Community and State-Hon

MEDICAL DIRECTOR- HAWAII (Part time) Responsibilities for a Medical Director include:

Conducts provider telephonic review and discussion, schedules on-site visits and shares tools, information and guidelines related to cost-effective health care delivery and quality of care

Responsible for appropriate utilization management

Clinical lead for healthcare affordability initiatives at the local market

Oversee the HEDIS data collection process, CAHPS (Consumer Assessment of Healthcare Providers and Systems) improvement, and drive Health Plan accreditation activities

Support all clinical quality initiatives and peer review processes

Effectively engage and bring understanding to our external constituents such as physicians, medical and specialty societies, hospitals and hospital associations, and state regulators

Deliver the clinical value proposition focused on quality, affordability and service, in support of the sales and growth activities including conducting Broker/Client presentations and participating in customer consultations

Responsible for identifying opportunities through participation in local medical expense committees or market reviews

What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, youll open doors for yourself that simply do not exist in any other organization, anywhere.
Medical Management for Hawaii Medicare (and Dual Eligible Medicare) is presently being managed by a vendor MDX. As of 12/1/10, Medical Management/UM will be managed by AmeriChoice. A part time Medical Director based in the local market is critical to manage inpatient bed days, as well as manage local relationships in the Provider Community.
Positions in this function are MDs and other clinical professionals who consult on various processes. The function includes roles which manage development and implementation of medical expense management initiatives. Advises leadership on improvement opportunities regarding medical expense programs and clinical activites that impact medical expense.
Provides leadership to and is accountable for the performance of managers and/or senior level professional staff.

Impact of work is most often at the operational or local business unit or market level.

Requirements:

MD or DO with an active, unrestricted license

Board Certified in an ABMS or AOBMS specialty

5+ years clinical practice experience -Intermediate or higher level of proficiency with managed care

2+ years Quality Management experience
UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, were removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.

Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.
View more jobs in Hawaii
Country: USA, State: Hawaii, City: Honolulu, Company: UnitedHealth Group.