Network Medical Director - St. Louis, MO - Midwest RBE - Field-based with Travel [15h Left]
Company: Optum
Location: Saint Louis
Posted on: July 2, 2025
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Job Description:
Optum MO is seeking a Medical Director to join our team in St.
Louis, MO. 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. Optum is a global organization
that delivers care, aided by technology to help millions of people
live healthier lives. The work you do with our team will directly
improve health outcomes by connecting people with the care,
pharmacy benefits, data and resources they need to feel their best.
Here, you will find a culture guided by diversity and inclusion,
talented peers, comprehensive benefits and career development
opportunities. Come make an impact on the communities we serve as
you help us advance health equity on a global scale. Join us to
start Caring. Connecting. Growing together. In support of OptumCare
Midwest Region’s mission, vision, and strategic goal to achieve the
quadruple aim by focusing on value-based care, the Network Medical
Director provides clinical leadership in guiding network medical
practices in the adoption of the key principles, tools,
technologies, and clinical support services essential to the
population health management in their designated market(s). This
opportunity provides direction, coordination, support, and
accountability to Primary care practices of various sizes,
multispecialty groups, hospitals, and ancillary facilities. The
Network Medical Director works collaboratively across a team to
help foster contracted PCP group engagement and performance within
the core fundamentals of Value Based Care delivery – STAR/HEDIS
performance, risk coding and documentation, and affordability. This
is an administrative role which works closely with the Client
Services Team in driving risk performance, patient engagement,
practice engagement with central supports like care management
programs, analytic platforms, and wrap around care services. The
Network Medical Director reports to the Chief Medical Office for
the OptumCare Midwest Region. This position requires you to be
located within the greater St. Louis area and willing to travel
within the state of Missouri with occasional overnight stays. It is
a field-based position requiring frequent face-to-face interfacing
will local network medical practices through the assigned state.
Primary Responsibilities: - Leads onboarding discussions with new
practices joining the network, focusing on setting appropriate and
customized performance expectations in collaboration with the
practice leaders - Establishes and messages clear standards and
expectations for the professional performance of the
provider/provider groups in their designated market(s) of the
Midwest Risk Bearing Entity (RBE) - Collaborates in teaching
clinicians and clinical operations teams about Medicare Risk
Adjustment, CMS STARs/HEDIS, and overall population health approach
to patient care in both formal presentations and off the cuff at
impromptu opportunities - Seeks to align Risk Adjustment, Quality,
and Affordability initiatives internally and translate into ways
network practices can actively engage in easily using these
resources - Operates with a tone of service and collaboration,
leading their designated market(s) - Collaboratively works with the
clinical and operational staff of the practices to develop
strategies and design solutions to improve the value of care,
clinical outcomes, affordability, and patient experience - Works
with RBE leaders to support integration of Quality Improvement
programs, Utilization Management reports, and Disease Management
programs - Reviews and trends group/provider performance data to
identify and strategize opportunities for improved performance -
Reports out at the Value Based Care Council, Quality Committee,
Regional Executive committee, or Provider Meetings as requested -
Travel within their assigned state(s) on a regular basis as needed
with occasional overnight travel What makes an Optum organization
different? - Be part of a best-in-class employee experience that
enables you to practice at the top of your license - We believe
that better care for clinicians equates to better care for patients
- We are influencing change collectively on a national scale while
still maintaining the culture and community of our local care
organizations - Practice medicine autonomously, with the support,
not restrictions, of a sustainable and thriving national health
care organization 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.
Required Qualifications: - M.D, D.O., or M.B.B.S. - Active
unrestricted license to practice medicine in Missouri - Board
certification in Family or Internal Medicine - 5 years of recent
clinic-based clinical practice experience after completing
residency training - 2 years of experience in a physician
leadership role in medical facility or related environment
preferred Well-versed in guiding conversations with clinicians,
operations teams, and executive leadership in various organizations
- Experience and knowledge of the local Missouri market - Knowledge
of managed care, including risk adjustment, affordability, quality
(STARs/HEDIS), utilization management, care management - Driver’s
license and access to reliable transportation - Ability to travel,
with occasional overnight travel Preferred Qualifications: - Recent
clinical practice experience in a Primary Care based setting -
Advanced knowledge of Medicare Advantage and SNP/D-SNP programs -
Ability to quickly customize the conversation with contracted
groups at various stages of population health development - Proven
track record of working well with Physicians, APRN, Physician
Assistants, Coders, Schedulers, Managers, Directors, and Executives
to assure care delivery is patient centered, timely, effective and
evidence-based approach to clinical care across all Primary Care
and specialty care participants - Solid understanding of local
market and healthcare landscape The salary range for this role is
$269,500 to $425,500 per year. Salary Range is defined as total
cash compensation at target. The actual range and pay mix of base
and bonus is variable based upon experience and metric achievement.
Pay is based on several factors including but not limited to local
labor markets, education, work experience, certifications, etc.
UnitedHealth Group complies with all minimum wage laws as
applicable. In addition to your salary, UnitedHealth Group offers
benefits such as, a comprehensive benefits package, incentive and
recognition programs, equity stock purchase and 401k contribution
(all benefits are subject to eligibility requirements). No matter
where or when you begin a career with UnitedHealth Group, you’ll
find a far-reaching choice of benefits and incentives. OptumCare is
an Equal Employment Opportunity employer under applicable law and
qualified applicants will receive consideration for employment
without regard to race, national origin, religion, age, color, sex,
sexual orientation, gender identity, disability, or protected
veteran status, or any other characteristic protected by local,
state, or federal laws, rules, or regulations. OptumCare is a
drug-free workplace. Candidates are required to pass a drug test
before beginning employment.
Keywords: Optum, St. Louis , Network Medical Director - St. Louis, MO - Midwest RBE - Field-based with Travel [15h Left], Healthcare , Saint Louis, Missouri