Job Details

ID #52998628
State South Carolina
City Sumter
Source UnitedHealth Group
Showed 2024-12-03
Date 2024-12-04
Deadline 2025-02-02
Category Et cetera
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Medical Director - Colonial Healthcare - Sumter, SC

South Carolina, Sumter
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Colonial Healthcare, part of the Optum family of businesses, is seeking a Medical Director to join our team in Sumter, SC. 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.For over forty years, we’ve dedicated ourselves to keeping our community healthy through forward-thinking services and patient-centered care. Colonial Family Practice, part of Optum, is pleased to offer you a chance for a rewarding health care career.Colonial Family Practice is located throughout Sumter, Columbia, Camden, and Manning, South Carolina. Colonial offers primary care, urgent care, pediatrics, pain management, behavioral health, neurology, lab and in house diagnostics with over with over 50 providers across 11 clinics.The Medical Director provides engaging leadership to the physicians and APCs through communication, guidance, and representation to support business goals and outcomes. The Medical Director is also an actively practicing Physician providing patient care.Primary Responsibilities:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Medical Director Functions:

Oversees Clinical Operations: Directly supervises Colonial Physicians and Advanced Practice Clinicians (APCs), ensuring optimal clinical performance and patient care

Performance Management: Sets clear performance goals and objectives, conducts regular quarterly performance reviews, and provides constructive feedback to improve individual and team performance

Administrative Leadership: Manages administrative functions for Physician and APC direct reports, including PTO scheduling, credentialing, licensing, and compliance with regulatory requirements

Understands the goals and aims of the business, including UHG and Optum’s Mission, Value Based Care, Medicare Advantage, Quality Metrics, membership growth strategies, Risk Adjustment, as well as other tools, programs, initiatives and pathways to success

In collaboration with the Market Medical Director explains, educates and coaches providers about the inputs, variables and effects of items such as Quality Metrics and STAR

Quality Measures which impact quality patient care. Ensures all physicians maintain a focus on Quality for our patients, physicians and payer partners

Understands the larger Optum organization and can work effectively with other units within the organization

Utilizes clinical and business knowledge to share best practices related to quality measures, translates business and financial issues to providers, assesses and advises practices regarding optimal practice efficiencies impacting clinical, operational and financial success

Builds strong and encouraging relationships with other providers. Creates an engaged team through frequent interactions. Maintains a meaningful work relationship with each practicing primary care provider

Educates, coaches and guides other providers, other medical directors, internal staff, teams, teammates, and others to achieve specific goals. Provides support and clinical expertise to the Quality Team. Acts as a clinical liaison with the Marketing and Talent Acquisition teams. Consults and advises the Compliance Committee, Quality and Clinic

Operations Teams and other internal teams. Acts as a liaison between practicing providers and Colonial Senior leadership

Sets goals to decrease cost of care, including operational/facility costs, low value and inefficient care, unneeded/high cost specialty referrals, high pharmacy spend, and other measures. Engages providers to create action plans as needed to ensure target goals are met

Provides guidance for clinical patient care issues identified by the clinical teams

Provides input and direction to the Operations Team on Specialty, Primary Care and facility adequacy and preferred high quality vendors

Holds proactive and strategic discussions with Analytics and market operations on the contents of the bonus structure

Communicates effectively by selection of appropriate communication tool to deliver critical messages, depending on audience and issue addressed

Identifies and mentors high potential Lead Physicians

Actively weighs in on non-clinical issues from a physician’s perspective

Identifies and provides information that is useful to providers, such as CMS rule changes, Optum System or Process changes)

Physician Functions:

Prescribes or administers treatment, therapy, medication, vaccination and other specialized medical care to treat or prevent illness, disease or injury

Orders, performs and interprets tests and analyzes records, reports and examination information to diagnose patients’ condition

Collects, records and maintains patient information such as medical history, family medical history, reports and examination results. Recordkeeping must be orderly and clinically complete as required by Colonial, part of Optum, and/or any applicable laws, ordinances, standards of medical practice, risk management or quality assurance programs, or as required by external accreditation organizations

Monitors patients’ conditions and progress through scheduling regular follow-up visits, lab or other test results. Reevaluates treatments as necessary

Explains procedures and discusses test results or prescribed treatments with the patient

Advises patients concerning diet, activity, hygiene and disease prevention. Provides health and wellness advice

Refers patients to medical specialists or other practitioners as necessary

Coordinates work with nurses, social workers, rehabilitation specialists, pharmacists, psychologists, and other health care providers

Directs and coordinates activities of clinical staff involved in the patients’ care along with the cooperation and input of practice management

Provides professional services to current patients of the practice, or to those who are referred to the practice

Actively markets the services of the office and organization by appropriate means, including actively participating in building rapport with other physicians and health care practitioners in the community

Cooperates and abides by the policies and decisions of AHN peer review, quality management, risk management, and utilization management programs

Works cooperatively with all AHN employees and management and presents a professional manner

Completes administrative duties and all other duties in a responsible and timely manner at all times

Coordinates with physician partners to provide “on call” coverage as needed. Provides coverage during evenings, weekends, holidays and vacations

Hold professional corporation ownership for Colonial

Other Functions:

Leads, actively participates in and attends meetings and participates on committees as requested

Other tasks and duties pertinent to practicing medicine within standard of care

Reviews current literature and attends training sessions and seminars to keep informed of new developments in the field

Performs other related duties and responsibilities as directed

Colonial Healthcare, joined Optum in 2024, is a primary care medical practice with additional specialties and ancillary diagnostic services that focuses on families. Colonial Healthcare aims to enhance the overall quality of life for their patients. To achieve this objective, they adopted a patient-centric approach that focuses on providing continuous, high-quality care across the entire lifespan, ranging from childhood to adulthood. The organization emphasizes on incorporating cutting-edge medical advancements while maintaining strong ties to family values and nurturing relationships with their patients. Together, we're making health care work better for everyoneYou’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:

A valid and unrestricted medical license in the state in which they practice and within the specialty (if Specialist)

5+ years of recent experience in clinical practice

5+ years of experience in a leadership role in a medical facility or related environment

Proven ability to remain in good standing with credentialing requirements

Proven ability to maintain clinical privileges at the hospitals used to treat patients

Diversity creates a healthier atmosphere: OptumCare is an 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.OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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