Regional Medical Director Value Based Care

GENERAL STATEMENT OF DUTIES

The Regional Medical Director formusculoskeletalValueBased Care (VBC) provides physician leadership and clinical oversight for allMSKvalue-basedcare initiatives within an assigned region. This role partners closely withvalue-basedcare managers operational leadersnetwork managersand market clinicians to develop and execute clinical strategies that improve quality outcomes patient experience andMSKtotal cost of care. The Regional Medical Directoroversees a multidisciplinaryclinical team andserves as a clinical liaison to clients and supports the effective deployment of digital and in-market clinical resources.

ESSENTIAL FUNCTIONS

Clinical Leadership & Strategy

• Work with Chief Medical Officer of ValueBased Care(CMO of VBC)to implement VBC strategies toensurehigh-quality cost-effective care is being delivered.

• Provide regional physician leadership forvalue-basedcare programs

• Overseeclinical strategies aligned with organizational qualityutilization and cost-management goals.

• Guide evidence-based clinical decision-making tooptimizepatient outcomes and performance against VBC metricsand targets.

Oversight of Clinical Resources

• Provide clinical oversight and direction for clinicians supportingvalue-basedcare initiatives.

• Collaborate with care managers advanced practice providers and other clinical team members to ensure coordinated high-quality care delivery.

• Supportdeployment and execution ofstandardized care pathways clinical protocols and population health initiatives across the region.

Provider Engagement & Education

• Supportdevelopmentand disseminationof metrics to be used in performance-based incentive programs for MSK and PCPclinicians tooptimizeprogram performance

• Partner with VBCnetworkmanagers to engage marketMSK and PCPclinicians in understandingHOPCosprogram expectations incentive eligibilityclinical performance data quality metrics andutilizationtrends.

• Educate and support providers on improvement strategies care redesign and best practices invalue-basedcare.

• Serve as a clinical advisor toregionalphysicians and practice leaders to driveadoptionof VBC initiatives.

Data-Driven Improvement

• Review and interpret clinical quality and financial data to identify opportunities for improvement.

• Collaborate with analytics and operational teams to translate data insights into actionable clinicaland operationalstrategies.

• Support continuous performance improvement through targeted interventions and clinician feedback.

• Lead regional initiatives to improveother quality measures such asHEDIS scores Star Ratings and other key VBC quality metrics

Client & Stakeholder Engagement

• Serve as a clinicalexpertin client-facing discussions.

• Communicate clinical strategy performance and improvement plans to internal and external stakeholders.

• Support contract performance reviews and strategic planning for value-based arrangements.

Governance & Compliance

• LeadQuality Committees in assigned regions engaging local physician leadership instrategies tooptimizeprogram performance.

• Works with other medical directors and CMOin thedevelopment and implementation of clinical protocols and evidence-based pathways tailored to VBC performance (e.g. reducing avoidable ER visits managing chronic conditions).

• Ensure clinical activities align with regulatory requirements accreditation standards and organizational policies.

• Promote a culture of quality accountability and patient-centered care across the region.

• Other duties as assigned

EDUCATION

• Medical Degree from accredited school asdeterminedby either the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association Commission on OsteopathicCollegeAccreditation (COCA)ANDmust have graduated from an accredited graduate medical education program (residency) asdeterminedby the Accreditation Council for Graduate Medical Education (ACGME)

EXPERIENCE

• Minimum oftenyearsofexperienceas a practicing physician.

• Must havestrongbackground in treating musculoskeletal conditionsand care delivery.

• Must haveat least 3 years in a leadership role within a VBC environment (ACO Medicare Advantagerisk bearing health system or provider organization payoror Clinically Integrated Network)or rolesimilar toaChiefMedicalOfficer.

KNOWLEDGE

• Knowledge of quality improvement philosophymodelsand processes within a healthcare organization.

• In-depth knowledge of quality management patient safety health information technology and peer review to enhance physician performance and practice efficiency

• Applicant should have adeep understandingofâVBC reimbursement modelsâ(populationhealth risk-based models sharedsavingsglobalcapitation).

• Knowledge of computerized statistical methodsofgathering quality metrics.

• Knowledge of medical records and clinical care processes.

• Knowledge of quality initiatives andhow to develop and implement strategic plans across a value-based care network.

• Shouldhaveproficiencyof knowledge in health informatics and population health management

SKILLS

• Skill in effective application of quality measures clinical guidelines and process management initiatives.

• Applicants shouldexhibitstrong emotional intelligence and the ability to influence clinicians who may not report to them directly

• Skill in consistently meeting quality requirements and educating providers and staff.

• Skill in using computer applications to effectively produce needed reports toidentifytrends.

• Skill in evaluationanalysisand presentation of data to providers and committees.

• Skill in communicating effectively with all stakeholders across the medicalecosystemincluding but not limited to physicians healthcare administrators/systemsand insurers.

• High emotional quotient with a mature self-confident demeanor that is effective and credible across all levels of the organization including senior management medical staff healthcareadministratorsand insurers.

• High levelofproficiencywith analytic toolsto display data for action-oriented results.

ABILITIES

• Proven ability to work cross-functionally in team environments to develop evaluate and execute best practice initiatives designed to promote excellence across the care continuum.

• Demonstrateabilityto generateinnovative ideas in health care delivery withabilityto influence andacquirenecessary resources across departments.

• Ability to work effectively with providershealthcare systems/administrators health insurersmanagementandstaff.

• Ability tosynthesizequality data andimplement programs to provide high quality value-based care.

• Ability to mentor and train staff in the clinic environment.

• Ability to communicate verbally and in writing to various levels of staff.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.

• Some travelas needed foradditionalmarkets.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.

• Some bending and stretching arerequired.

• Manual dexterity using a calculator and computer keyboard.

ORGANIZATIONAL REQUIREMENTS

• HOPCoMission Vision and Values must be read and signed.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities knowledge skills abilities and working conditions may change as needs evolve.

Required Experience:

Director