Sr. Medical Director
Eden Prairie , Mn, Us
Sr. National Medical DirectorOptum, Inc. & Optum Senior Community CareSep 2021 - Dec 2022Denver, COEngaged as subject matter expert on national level to advise and lead on COVID-19, influenza, and other infectious diseases, as board-certified Infectious diseases physician. Served as subject matter expert for team utilizing machine learning and artificial intelligence to develop predictive models of each disease. Developed and managed infection control policies for Optum and educated thousands of providers at weekly question-and-answer sessions.* Oversaw day-to-day medical operations of Medicare Advantage Dual Eligible (Medicare and Medicaid) Program, including supervision of nurse practitioners, new business development, contracting, expense management, quality initiatives, utilization management, and physician relationships.* Instructed on common medical issues and regularly scheduled meetings to provide leadership, development, and forum for communication, ensuring coordination and collaboration with organization.* Collaborated with partner organizations and managed relationships with contracted skilled nursing facilities and provider groups.* Advised on medical coding and risk adjustment factor scores (RAF).* Helped design and implement clinical programs and initiatives with internal and external partners.* Reviewed metrics, monthly outcomes, and benchmarks of STARs, HEDIS, and UM.* Delivered internal and external presentations to professional societies, peers, and interdisciplinary groups.