Physician - Medical Director - Tiger Team
Humana

Atlanta, Georgia

Posted in Insurance


This job has expired.

Job Info


Description

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


This job has expired.

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