At WellMed, our focus and mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. We are innovators in preventative healthcare, striving to change the face of healthcare delivery for seniors. Our providers and support staff are selected for their dedication to the senior population and focus on preventative, proactive patient care. WellMed is now part of the OptumHealth division under the greater UnitedHealth Group umbrella. Primary Responsibilities:Educate primary care physicians on systems, structure, processes and outcomes that are necessary for assurance of regulatory compliance related to market activitiesDevelop strategies for improving all aspects of market performance including coding, documentation, membership and medical managementConduct post service reviews issued for medical necessity and benefits determination codingAnalyze aggregate data and reports to primary care physicianSupervise functions of Care CoordinationAssess the effectiveness of the specialty network to ensure members have access to multi-specialties within their demographic areaEducate primary care network and assists in problem resolutionEvaluate performance of physicians with regard to goals and objectivesInterface with physicians / medical group staff professionally developing credibilityDelivery timely response / communications to physicians on all needed follow up issuesProvide quality assurance and education of current medical technologies, review criteria, accepted practice of medicine guidelinesOther related duties as assigned / needed Professional / Physician DevelopmentActively facilitate training and weekly, monthly etc. physician meetingsGuide and educate new physicians to ensure understanding of company policy and resources available for physician supportEncourage teamwork and cooperation amongst medical group staffs and prepare for cross training and float positionsAssist in the growth and development of subordinates by mentoring, sharing knowledge and promoting continued educationAttend continuing education classes to keep abreast of medical advancements and innovative practice guidelines
Required Qualifications: Current, unrestricted Florida Medical LicenseMD or DOBoard certification in a specialtyFive or more years of clinical practice experienceProficiency with Microsoft Excel, Word, PowerPoint, Outlook Must be able to travel in 1 hour radius from office Preferred Qualifications:Physician network development and / or provider relationship experienceMedicare AdvantageTwo years of experience working in a managed care health plan environmentBoard Certified Family Practitioner or Internal Medical Specialist Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 300,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) 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. Job Keywords: Healthcare, Clinical Practice, Physician, Managed Care, Medical, Director, Licensed, Certified, WellMed, Florida
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.