Market Medical Director - Rhode Island

Description

The ConcertoCare Medical Director manages clinical care delivery and performance in the market in collaborative partnership with the Market Operations Leader. Key activities include support and oversight of clinical care delivered by field-based clinical practitioners, data-driven and KPI-directed clinical performance management, direct patient care for high-risk patients, relationship support for key partnerships, and daily personnel management for clinical practitioners. This position reports to the Associate Chief Medical Officer.

This is an ideal position for a physician leader who seeks an opportunity for “top of license” clinical practice supporting a team of advanced practice providers, enjoys a collaborative multidisciplinary team-based approach to care, and is excited to engage in developing and nurturing our innovative, value-based clinical model focused on caring for patients with complex needs who are inadequately served by traditional healthcare delivery systems.
 

RESPONSIBILITIES

• Clinical support and oversight for care delivered by the clinical provider team, including but not limited to supervision of care quality, clinical decision-making, and compliance.
• Management of local provider teams including hiring, training, coaching, counseling, supporting, and evaluating direct reports.
• Clinical performance management including ongoing clinical data evaluation and strategic deployment of clinical team resources to achieve KPI targets.
• Dyad partnership with the market leader, including co-ownership of clinical and financial outcomes and engagement in strategic design, planning, and implementation of data-driven initiatives, processes, and programs to meet performance targets and drive growth/engagement.
• Dyad partnership with market leaders to build and develop clinical partnerships and health plan relationships to drive performance in local market.
• Act as a consultative physician focused on stabilizing the frailest and most vulnerable patients within the population.
• Direct patient care including annual wellness, continuity care, urgent care, and care transitions visit types in home, clinic, congregate living, and/or skilled nursing facility-based settings for highest-risk patients.
• Participation in care team huddles to provide clinical input, support individualized care plan development, and champion value-based care strategies to drive clinical outcomes and performance.
• Collaborative practice agreement supports as needed per state regulations.
• Lead clinical liaison for local clinical community partnerships including providers, SNF, hospitals, and other clinical partners to support individual patient care needs and to ensure successful ongoing clinical collaboration, communication, and performance improvement.
• Medical director-level leadership for ACO REACH (DCE) and other programs as required.
• Engagement in the development and implementation of new clinical initiatives and championing the change with the local team for national operational workflows, technology innovation, and care quality initiatives.
• Adherence to medical policies, protocols, criteria, and clinical guidelines to ensure best practices are maintained for clinically effective and efficient care delivery.
• Adherence to compliance policies, procedures, and standards of conduct including all applicable laws and regulations including promotion of compliant communication and behaviors amongst all team members.
• Oversee market risk management, population health management (in partnership with directors of Population Health Teams), case review, outreach programs, HEDIS reporting, site visit review coordination, triage, provider orientation, credentialing, etc
• Participate in telephonic on-call coverage that requires telephonic triage on an as-needed basis
• Other organizational and/or market-specific duties as assigned.

QUALIFICATIONS

• Graduation from an accredited medical school.
• Active medical licensure in New York.
• Active DEA licensure and state-specific controlled substance registration, as applicable.
• Completion of residency training in Internal Medicine or Family Medicine and a minimum of 4 years of post-training clinical experience.
• Board certification in Internal Medicine or Family Medicine required. If board eligible, board certification must be completed within less than one year.
• Board certification in Geriatric Medicine or Palliative Care preferred.
• Certification in basic life support (BLS) required.
• Leadership and people management skills and have successfully demonstrated the ability to build and develop a strong medical team.
• Possess in-depth knowledge