accountingmanager | Medical Director for CareServices Audits in Minneapolis, MN
Medical Director for CareServices Audits
$93,150.00 - 131,240.00 / Year *
201 W 70th St
Minneapolis, MN 55423
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The employer operates within the healthcare sector.
Work jointly with an operations, technical, and economic counterpoint towards execution on CP related initiatives such as risk adjustment and quality
Align and improve current clinical audit capabilities to deliver best in class clinical performance
Identify opportunities to improve risk and quality and work within a matrixed team to lead and drive strategy
Be a precise clinical reference for clarifications, present both remotely and in-person, relevant clinical information with a focus on risk adjustment, quality, CMS 5 Star, and other pay for performance based programs
Assist in coordination of Clinical Performance efforts with senior leadership across OptumCare, Optum, and Payers
Provide direct provider to provider & provider to staff (clinical and non-clinical) support on interpreting data and analytics
Provide direct provider mentoring in 1:1, small group, and large group sessions over time as needed
Monitor and audit the progress of providers and develop tailored strategies to improve performance
Provide clinical insight and consultation to other members of the Clinical Performance team, and other parts of the organization on a variety of projects
Provides medical-administrative leadership
Participates in regulatory and accreditation activities, as applicable
Travel up to 50% of the time nationally
MD or DO
Active, unrestricted physician license
Current board certification in ABMS or AOA specialty
5+ years of experience working directly with CMS 5 Star, HEDIS, Risk Adjustment, and other Pay for Performance Programs
7+ years in healthcare
5+ years in management of clinical staff
5+ years active Primary Care practice experience
Strong background in quality improvement and risk adjustment strategy/direction
Demonstrated ability to work in matrix organization and think strategically and tactically
Proven track record in excellent relationship building (peers, leadership)
Strong communication and presentation skills with ability to deliver complex messages to variety of audiences
Influential leader who builds credibility with medical staff, providers
Sound project and change management skills
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.
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