Medical Director Managed Care Physician Engagement

The Medical Director of Physician Engagement is responsible for developing and driving implementation of physician and APP focused strategies that aim to drive new business, network expansion and the enhancement of population health, health equity, and integrated care programs.

This role serves as the strategic liaison, responsible for engaging physicians / APPs across the markets in critical business and clinical initiatives. This role oversees all physician / APP engagement teams as well as provider relations teams focused on network education, frontline communication, issue resolution, and network expansion. They partner with Network Management and Contracting leadership to support the development of Physician / APP relationships needed to enhance the networks. They collaborate with Clinical Analytics, Clinical Strategy, and Quality Management to develop and enhance member health and wellness programs, while also working with health plan leadership to explore opportunities for pilot programs or grants to build healthier communities.

This role ensures the integrity of innovative care solutions while staying current with best clinical practices and aligning with the CommonSpirit mission. The role involves close collaboration with cross-functional stakeholders across the enterprise to align and drive toward shared goals.

Responsibilities include :

• Collaborate with the Chief Medical Officer, Managed Care and executive leadership to develop, implement, and oversee physician / APP focused clinical initiatives.
• Develop, mentor, and oversee the provider relations teams, ensuring performance and compliance requirements are met.
• Serve as a point of escalation to support resolution of physician / APP issues.
• Partner closely with Operations Leadership to ensure consistent physician / APP interactions and experience with all internal Managed Care operations such as enrollment, claims operations and provider contracting departments
• Play a key role in new business development and implementation, overseeing recruitment, training of clinical team members, and transition to local leadership.
• Support the implementation of quality improvement tools or pilots to enhance care solutions, drive efficiency, and address impactable variation.
• Serve as the physician medical director for the Population Health Services Organization (PHSO) quality division.
• Analyze Physician / APP KPIs to identify improvement opportunities for clinical programs and operations.
• Evaluate and escalate concerns that may impact patients or care teams.
• Consult with stakeholders to identify and oversee training and special project needs.
• Contribute to the strategy for the national PHSO operating platform, including systems like EMR, population health / care management, remote patient monitoring, and CRM.
• Provide backup support to the Medical Director of Utilization Management in medical review activities, peer-to-peer consultations, appeals and grievances and other related duties.
• Job Requirements
• Minimum Qualifications :
• Minimum 7 years experience practicing medicine as a physician within a managed care setting
• Minimum 5 years experience in a value-based provider group or managed care setting
• Minimum 2 years experience in medical administration, preferably with an IPA
• Current MD / DO license to practice medicine within the State of California; Board Certification is required, preferably in a primary care specialty
• Management / leadership experience in healthcare setting
• Knowledge of clinical standards of care, NCQA requirements, CMS guidelines, and Medicaid / Medicare programs and dual eligible populations, and benefit systems is preferred.
• HEDIS / Stars and HCC / Risk adjustment knowledge.

\#LI-DH

• Where You'll Work

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health's Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

One Community. One Mission. One California

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• Pay Range

$118.62 - $176.44 / hour

We are an equal opportunity / affirmative action employer.