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National ACO Medical Director
Astrana HealthUnited StatesRemotefull_timeVerifiedPosted 20 Sept 2024
About the role
Title: National ACO Medical Director Department – ACO About the Role:The National ACO Medical Director will oversee and guide the operations and strategic direction for one of Astrana Health’s largest lines of business, our Accountable Care Organization. This physician leader will play a critical role in driving clinical initiatives to optimize quality of care, providing leadership to our independent providers under a value-based care framework, and serving as a liaison for all care partners within the ACO network. The ideal candidate will have extensive experience in provider-facing leadership within a value-based care ecosystem, a deep understanding of CMS guidelines surrounding ACOs and quality metrics, and a proven track record of implementing data-driven strategy in a healthcare setting. What You’ll Do:
- Provider clinical oversight, expertise, and leadership to the ACO network.
- Collaborate with and provide feedback to primary care physicians, specialists, and other healthcare professionals to promote high-quality, efficient, evidenced-based care.
- Develop and implement strategies to improve quality of care within the ACO rates in alignment with organizational goals and national industry benchmarks.
- Partner with advanced care management team to develop, implement, and evaluate disease management and readmission prevention programs.
- Develop and execute plans to integrate new markets into the ACO network.
- Analyze and monitor data to establish quality metrics, benchmarks, and performance targets to monitor and improve clinical outcomes, patient safety, and member satisfaction.
- Facilitate effective communication and collaboration among network physicians, promoting a team-based approach.
- Responsible for presenting to external entities and conveying the unity and commitment of the medical staff to the organization's mission and values.
- Establish and maintain clinical governance structures to promote transparency and accountability in clinical decision-making and patient care.
- Work with the financial team to manage the budget for clinical services, ensuring the ACO meets financial/payer goals and cost-effectiveness while maintaining high-quality care.
- Develop and implement strategies to improve the health of the population served by the organization, including preventive care and chronic disease management.
- Collaborate with executive team to develop long-term strategies for the ACO and assist in scaling the ACO’s footprint/network partnerships on a national scale.
- Ensure compliance with federal, state, and local healthcare regulations and ACO program requirements.
- MD or DO degree with active medical license in good standing.
- Board certification in a relevant medical specialty.
- Minimum of 10 years of clinical experience, with at least 5 years in a clinical operations or managed care leadership role.
- Strong understanding of managed care principles, healthcare delivery systems, and regulatory requirements.
- Proven experience in developing and implementing quality improvement programs.
- Excellent leadership, communication, and interpersonal skills.
- Ability to analyze complex clinical data and translate findings into actionable strategies.
- Demonstrated ability to lead and inspire teams in a dynamic and dispersed healthcare environment.
- MBA, MHA, or MPH degree.
- Deep understanding of healthcare markets across various states.
- Leadership experience overseeing an ACO network.
- Internal Medicine or Family Medicine background.
- Experience as an independent provider.
- Familiarity with healthcare technology and data analytics tools.
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