9 days old

Nephrology Medical Director - Wellmed - San Antonio, TX

San Antonio, TX 78205
  • Job Code
    877989

Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered.


We are looking for a Nephrology Medical Director to join our WellMed medical team in the San Antonio office. The medical director is a key member of the market leadership team who shares responsibility for the Nephrology clinical protocols and strategic planning with other members of the team. You will work to drive measurable and meaningful improvement in the use of evidence-based medicine to improve affordability. You can make a difference in serving our Medicare Advantage, Medicare, Medicaid and commercial members and plan sponsors. We are looking for a Nephrology medical director who understands the value based approach to medical care and is comfortable working in a Medicare Advantage setting as well as a Fee for Service setting. You will be responsible for conducting Patient Care Coordination meetings weekly with your care management team and you should be able to understand risk adjustment initiatives. In addition, you should have the ability to understand the metrics that drive clinical quality initiatives in the primary care medical home and joint commission arenas. You will be expected to work collaboratively with operations and matrix partners. You will also be required to become competent in Tableau and other informatics/reports required to achieve market metrics/objectives. The Nephrology medical director is responsible for improving the quality and efficiency of medical care in his/her clinics of responsibility. 
 
Primary Responsibilities:

  • Work to improve quality and promote evidence-based medicine

  • Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement

  • Support initiatives that enhance quality throughout our national network

  • Ensure the right service is provided at the right time for each member 

  • Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review

  • Success in this technology-heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production-driven setting

You'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.

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Posted: 2020-06-24 Expires: 2020-07-24

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Nephrology Medical Director - Wellmed - San Antonio, TX

UnitedHealth Group
San Antonio, TX 78205

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