Medical Director Managed Care Physician Engagement
Share
Job Location:
Bakersfield, CA - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Department:
Job Summary
Where Youll Work
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.
Job Summary and Responsibilities
***This position will be hybrid work from home (within California) and in-clinic requiring up to 50% travel to provider offices primarily in the Bakersfield/Central CA region.
Position Summary:
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
Required Experience:
Director
Key Skills
- EMR Systems
- Post Residency Experience
- Occupational Health Experience
- Clinical Research
- Managed Care
- Primary Care Experience
- Medical Management
- Utilization Management
- Clinical Development
- Clinical Trials
- Leadership Experience
- Medicare
About Company
Dignity Health provides compassionate, high-quality, affordable health care services throughout Arizona, California and Nevada. Schedule an appointment today!
