Senior Medical Director Primary Care & Population Health

Description

Title: Senior Medical Director Primary Care &Population Health

Location: Fountain Valley, CA

Department: Administration

Status: Full-time

Shift: Day

Pay Range*: $/annually

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

Provides medical, clinical integration, and value transformation leadership for the MemorialCare Medical Foundation (MCMF) and MemorialCare Medical Group (MCMG) via work with physicians, physician leaders, population health teams and operational partners. Directs, monitors, evaluates and coordinates activities of the MCMG physicians, advanced care practitioners and medical group division employees engaged in medical care and medical management services to assure high value patient care and experience. Develops and monitors medical policy and operations. Serves in dyad relationship with both the MCMF VP, Medical Group Operations and MCMF VP, Population Health. Serves as a critical member of the Chief Medical Officer (CMO) leadership team, in partnership with the Senior Medical Director for Specialty Services, in developing clinical transformation strategies and clinical integration priorities to improve MCMF/MCMG overall value performance. Monitors MCMG PCPs, AHPs and office-based medical sub-specialty providers to ensure appropriate staffing along with compliance with all legal and regulatory requirements.

Essential Functions and Responsibilities of the Job

·Assists the CMO in developing and implementing annual performance priorities in alignment with the MCMF and MHS strategic plan(s) and helps inform related annual budget planning.

·Implements and directs the transformation of the outpatient delivery system to a patient-centered and fully integrated delivery system in collaboration with physicians and staff.

·Assists the CMO with strategic planning for primary care model design and transformation to enhance care coordination and team-based care, population-based physician staffing mix, growth, and office locations.

·In partnership with HR and Sr Medical Director, Specialty Care, directs provider recruitment efforts to support MCMG, MCMF and MHS strategic goals.

·Supports the development of best practices, evidence-based medicine and the design and integration of clinical decision support tools and e-workflow tools to support high-Quality care and decrease clinical variation across providers.

·Assists the CMO and other Medical Directors in the implementation of MCMF informatics, patient experience, quality improvement and performance improvement (P4P) initiatives.

·Assists with the integration of physicians into the medical group.

·Partners with Utilization Management/Case Management/Disease Management program leads to advance services alignment, patient access and flow, and network integrity.

·Key participant in the Primary Care Physician (PCP) and Specialist credentialing process.

·Serves as a key member on the Quality & Safety Executive Committee and associated sub-committees related to performance improvement, clinical variation reduction, peer review, and credentialing.

·Provides oversight, in partnership with MCMF HR and MCMG leadership, of provider grievance review processes, provider counseling and review, and ongoing performance management and education.

·MCMF/MCMG Meetings include but are not limited to:MCMG Board of Directors, MCMG Leadership Council, Executive Management Team, MCMG Executive Committee, MCMF JOC and Regional Medical Director Forum,

·Supports the coordination and administration of annual MCMG Physician Awards.

·Develops and implements Continuing Medical Education (CME) and other educational activities including Grand Rounds.

·Supports the oversight and advancement of established population health management services and programs and other special population-based clinics & services as developed. Assists the CMO in the design & development of new clinics and services to better manage chronic disease and prevention and complex and advanced serious illness.

·In partnership with CMO, HR, and Medical Group leaders, oversees MCMF/MCMG provider onboarding, engagement, and wellness strategies to enhance provider alignment, joy in work, retention, and overall experience.

·Direct management and oversight of the Regional Medical Directors with cascaded management of facility medical directors to ensure alignment of goals and standard work consistent with the provider rules and regulations.

·Promotes effective communication among providers, Associate Medical Directors, Facility Medical Directors, Regional Medical Directors and staff.

·Dyad to the VP, Medical Group Operations to ensure offices operate efficiently, with continuous performance management systems to drive improvement in quality, safety, coordination, access, productivity, patient experience, population health and value.

·Collaborates with Medical Management, the Regional Medical Directors, Facility Medical Directors and Associate Medical Directors to manage specialty claims cost.

·Works closely with Network Management and Provider Relations to ensure effective education and maintenance of outside specialty network.

·Monitors and directs company compliance with government and contractual requirements. Monitors provider charge analysis, charge audits, documentation and adherence to Medicare guidelines.

·Monitors provider profile data reports and provides consultation and interventions directly or through the Regional and/or Facility Medical Director as needed, including disciplinary action per policy/procedure and productivity gaps.

·Works with Medical Directors and Associate Medical Directors to facilitate quality assurance and other provider activities.

·Supports the development of the compensation policy for Physicians and Advanced Care Practitioners and works closely with the Regional Medical Directors and CFO on individual provider compensation changes and market adjustments.

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our for more information about our Benefits and Rewards.

Qualifications

Minimum Requirements

Qualifications/Work Experience:

·Successful 10+ years clinical practice experience, strong preference in primary care within an integrated health system

·Min 5+ years’ experience in a medical leadership position in a medical group setting, such as Associate CMO, Medical Director/Chair of Primary Care or Population Health/Care Management

·Min 5+ years’ experience with managed care operations, QM/UM, regulatory and compliance rules

·Clinical operations and business experience with care model design, clinical transformation design and implementation

·Experience with multi-specialty medical group and medical foundation governance and organizational matrices

·Leadership experience in performance management, lean principles, Just Culture and HRO

·Demonstrated experience in Physician and AHP management, HR practices, leadership development, & engagement

·Demonstrated ability with physician alignment, team building and negotiation

·Familiarity with data analysis, statistical evaluation, visual management, & provider engagement to drive clinical variation reduction and performance

·Willingness to participate in education programs

·Enthusiasm for clinical/practice/care model innovation and technological advancement

Education/Licensure/Certification:

·MD/DO with current license by California Medical Board

·Board Certification in specialty, strong preference for FM/IM