Physician - Medical Director - Tiger Team
Partners in Primary Care

Job Info

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Description

Humana's Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country, operating over 175 centers across eight states under two brands: CenterWell & Conviva. Operating as payor-agnostic, wholly owned subsidiary of Humana, our centers put the unique needs of seniors at the center of everything we do. Our clinics offer a team-based care model, where our physicians lead a multi-disciplinary care team supporting patient's physical, emotional, and social wellness.
The New Target Market MD will be responsible for mentoring and training new market clinicians in value based principles for a senior focused patient care model. They will be the clinical subject matter expert on best practice treatment for chronic patients with a team based approach to care. This role will require 50% work travel to different expansion markets for days to weeks at a time.

Responsibilities

With the market Chief Medical Officer, the Target Market Team MD teaches and trains clinical personnel around the organization's care team approach to quality based senior focused medicine and new market introduction. Serves as the Subject Matter Expert (SME) on clinical value based care practices and responsible for building and maintaining training content for the CDO University. Responsible for teaching best practices in documenting and treating chronic diseases appropriately.

• Excellent communication skills; written and verbal
• Demonstrate a high level of skill with interpersonal relationships and communications.
• Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value based relationship environment.
• Fosters a cooperative and harmonious working climate conducive to maximize employee morale and productivity.
• Plan, organize, and supervise training for Primary Care Physicians and extenders.
• Responsible for medical interpretation, reviews, and decisions as required for plan administration.
• Oversee the development, revision, and implementation of policies and procedures, systems, programs and standards for health care services.
• Represent the organization in recruiting and marketing events.
• Knowledge of HEDIS quality indicators.
• Assess, develop and recommend strategies for compliance with regulatory requirements.
• Identify trends of over- and under-utilization and implement actions plans to improve.
• Teach and orient physicians in the correct application of approved guidelines. .
• Guide and enforce Perfect Service Standards (Customer Service) when teaching clinicians.
• Assist in the development and delivery of training as it relates to MRA best practices.
• Develop and hold accountable contracted physicians for PIPC in multiple markets.

• Role Essentials
  • Medical staff leadership experience for a large provider group practice, physician practice management organization, hospital/hospital system, or an MCO (preferably with a physician group practice component)
  • Knowledge of Medicaid and Medicare programs, specifically Medicare Advantage
  • Strong knowledge of MA coding and documentation policies and procedures in a value based relationship
  • Experience working with physicians to strategize and develop measurable improvements the quality of clinical care and patient satisfaction
  • Medical quality and performance improvement experience
  • Utilization review experience

• EDUCATION/CREDENTIALS/REQUIREMENTS:
  • Licensure requirements of the state of jurisdiction and ability to maintain licensure
  • Graduate of accredited MD or DO program of accredited university
  • Board Certification in Family Medicine, Internal Medicine or Geriatric Medicine with continued certification throughout employment

• JOB RELATED EXPERIENCE:
  • Minimum of five to seven years as a PCP.
  • Superior patient/customer service.
  • Basic computer skills, including email and EMR.
  • Minimum of 3 years seeing patients daily in a PCP Medicare Advantage group environment.
  • Experience with managing chronic patients over a minimum of a 2 year period of time with specific experience around appropriate disease recognition, coding and documentation.

• Role Desirables
  • Knowledgeable of the target expansion area and with extensive physician/colleague network.
  • Published papers and presentations within the Healthcare community
  • Had attended Medical or Residency in the area of expansion.

Additional Info:

#physicianrecruiter

50% work travel

Scheduled Weekly Hours

40

Equal Opportunity Employer
It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact yourcareer@humana.com for assistance.

CenterWell Health & Safety Policy
CenterWell, a Humana subsidiary, will require full vaccination for associates and select contractors who conduct work outside of their home. This applies to those who work within our facilities; interact directly with members and patients; attend in-person meetings or trainings; and/or represent CenterWell at events or volunteer activities. Medical and religious exemptions will be available, and this policy will not supersede state or local laws. Learn more

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CenterWell will never ask, nor require a candidate to provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact yourcareer@humana.com to validate the request.

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