Director Utilization Management Jobs in Kansas (NOW HIRING)

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The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care (VBC) principles. This market/center-specific role requires flexibility to adapt responsibilities as needed and demands a unique blend of clinical management, financial/business acumen, and strategic partnership to optimize patient care and business outcomes.
Leadership & Organizational Management
• Understand organizational & market priorities, trends, and goals, to develop a clinical strategy to advance clinical talent and performance
• Interview, hire, and supervise clinical teams to staff and develop a high-quality clinical team with strong engagement, patient-first culture, and talent retention
• Closely engage and communicate with clinicians and care teams, conducting weekly onsite center visits, holding regular individual 1:1s and clinician pod meetings, and actively participating in monthly leadership meetings
• Deeply understand, support, and improve primary care clinician performance through understanding of individual & care team context, effective use of data, and effective coaching of clinicians and care teams
• Engage in regular market performance (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical initiatives
• Champion our senior-focused primary care strategic vision and initiatives and foster stakeholder relationships, including health plan partners, healthcare providers (e.g. specialists, hospitals) and social services, to improve our community of care locally
• Represent CenterWell/Conviva brands in local communities and related media activities while collaborating with the recruitment team to build and network a pipeline of high-quality primary care clinicians (physicians, APPs, MAs, and other clinical professionals)
• Utilize clinical performance dashboards and data tools to support stack ranking, performance analysis, and targeted strategy development
• Foster a culture of continuous learning and professional growth among clinical teams
Clinical/Patient Management
• Foster a robust patient-centered and value-based clinical vision, strategy, and culture locally that orients care teams around excellence in patient care, teamwork, outcomes
• Deliver leading clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization
• Periodically review clinician charts to identify opportunities in care, ensuring clinical assessments are accurate and that performance improvement and coaching initiatives are precise
• Identify critical issues for high-risk patients during case reviews & other forums, and model and drive clinical excellence
• Conduct root cause analysis of care opportunities from both individual, team, and systems perspectives and partner with clinical and operational colleagues to improve high-reliability care as a team
• Ensure clinicians effectively co-manage high-risk episodes of care and patients with partnered Care Integration Team (CIT) resources and programs for transitions of care management (TCM), high-risk patient management (HRPM), and social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization
• Monitor and manage daily patient care and initiatives to improve team-based key performance indicators (KPIs), such as patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals
• Personally deliver high-quality primary care and demonstrate a high degree of patient care ownership and clinical excellence in age-friendly senior primary care including health promotion & prevention, disease management, effective specialist & hospital co-management, and complex care management
• Spend % of time on direct patient care, with remaining time dedicated to administrative responsibilities. The percentage of time may vary by market needs and by staffing levels throughout the year
• Support clinical quality performance improvement in areas such as MRA, Stars, and prevention of unnecessary utilization through provider education and coaching
• Promote team-based care delivery and foster collaboration across interdisciplinary teams
Dyad Partnership
• Collaborate with operational leaders (Associate Operations Director and/or Market President) and Shared Services partners to align on clinical and operational goals, strategic planning, and budgeting
• Maintain regular communication to align on performance, strategies, and team communication and management, ensuring unified decision-making and consistent messaging for cohesive leadership
• Work together towards common goals that support the mission, vision, values, and overall patient experience outcomes, managing clinic/market dynamics and engagement
• Partner on strategic and operational insights, including capital and operational budgeting, and monitor clinical & financial performance and metrics
• Review clinician schedules and incentive plans to align with patient care access and management goals
Required Qualifications
• Graduate of an accredited medical school (MD/DO) with a current medical license, maintaining licensure requirements of the state of jurisdiction
• Board Certification in Family Medicine, Internal Medicine or Geriatric Medicine
• Minimum five years of experience in outpatient practice, with clinical experience in primary care, senior health, and value-based care (VBC)
• Minimum three years of experience successfully leading clinicians in a leadership role with demonstrated impact on clinician talent, culture, and performance, and effective partnership with operations and supporting teams
• Skilled in use of clinical technology platforms and resources, such as EMR systems (e.g. athenahealth, Epic, eClinicalWorks), voice documentation tools (e.g. Dragon, Abridge), and clinical evidence & pathway resources (e.g. UpToDate)
• This role is considered patient-facing and is part of CenterWell s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
• Candidates selected for this job will be required to adhere to Humana s flu vaccine policy
Equal Opportunity Employer
We are proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.