National Medical Director - Optum HouseCalls Clinical Field Operations - Remote

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

Oversight of the National HouseCalls program which delivers in home annual wellness exam to all qualified Medicare Advantage Members, Community and State members and several other plans.

HouseCalls is a unique program designed to enhance and improve quality care for our members. We provide in home assessments to members and tailor our care based on the individual and their health care needs.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Clinical Model Support:
  • Support clinical strategy, efficacy and effectiveness of HouseCalls referrals; internally and partner programs
  • Lead coordinating the ongoing HouseCalls value proposition studies through various values analytic initiatives and studies
  • eHouseCalls documentation improvements in partnership with clinical performance team
  • Oversight of CLIA waivers
  • Policies and Procedure support/review
  • Regulatory change implementation and review
  • Updating standards of care/protocols
  • Product and model development support
• Quality:
  • Individual quality of care case review
  • Review/guide QOC and peer review procedures
  • Credentialing
  • Partner with clinical performance team with documentation initiatives, helping to drive strategy
  • Stars initiatives
• Relationships:
  • Lead relationship with collab physicians (providing misguidance to APCs, non-compliance with requirements, help recruit/interview)
  • Outreach to PCP complaints regarding general HouseCalls concerns
  • Peer Review meetings/oversight
  • Engagement strategies with providers, members and health plan
  • Implementation of new clients
  • Ongoing support of relationship with health plan (QOC review, GPOC, etc.)
  • Vendor support (medical director)

Required Qualifications:

• MD or DO degree
  • Active, unrestricted physician state license
  • Current board certification in ABMS or AOA specialty
  • Clinical practice experience post residency
  • Solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles

Preferred Qualifications:

• Hands-on utilization and/or quality management experience
  • Project management or active project participation experience
  • Substantial experience in using electronic clinical systems