Regional Medical Director-CenterWell-Nashville

Profile

Description

CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, Missouri, Nevada, Kentucky, Tennesseee, North Carolina, South Carolina and Texas. CenterWell Senior Primary Care has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary care combined with an excellent patient experience. CenterWell Senior Primary Care has experience in both the treatment and management of most chronic and acute-care conditions. The practices also provide health education and value-added, well-being services at the centers and around their neighborhoods to help both patients and community members improve their health.

At CenterWell Senior Primary Care, we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all.

Responsibilities

As a Regional Medical Director you will plan, organize, manage and supervise health care services offered in the medical centers. Work in conjunction with the Center Medical Directors to motivate and provide medical direction in pursuit of cost effective, quality healthcare.

Plan, organize, manage and supervise the roles of the Center Medical Directors.

Identify physician recruitment needs and collaborate in the hiring and contracting of providers.

Establish work schedules and assignments for medical staff according to workload, space and equipment and center needs.

Oversee daily operations of physician services.

Build strong relationship with specialist, hospitalist, SNF and other providers to form a narrow network of quality service focused on senior population health

Responsible for medical interpretation, reviews, and decisions as required for plan administration.

Monitor medical performance and provide guidance to ensure that the quality of care being provided meets appropriate standards and to ensure cost-effective utilization practices.

Oversee the development, revision, and implementation of policies and procedures, systems, programs and standards for health care services.

Represent the organization in community and marketing events.

Develop and maintain compliance with the departmental and physician budgets.

Assess, develop and recommend strategies for compliance with regulatory requirements.

Develop and maintain an effective relationship with all departments providing medical guidance and expertise.

Develop, implement and monitor the outcomes of utilization review and disease management programs to meet the quality and cost expectation of.

Identify trends of over- and under-utilization and implement actions plans to improve.

Direct and orient physicians in the correct application of approved guidelines. .

Oversee the operations of the wellness activities and medical department.

Guide and enforce Perfect Service Standards (Customer Service).

Other duties as requested

Required Qualifications

8 or more years of technical experience

5 or more years of management experience

Licensure requirements of the state of jurisdiction; Kansas or Missouri

Graduate of accredited MD or DO program of accredited university

Demonstrated success driving value based care models

Leadership experience within a large primary care or multi-specialty group practice, physician practice management organization, hospital/hospital system, or a managed care organization

Board Certification in Family Medicine, Internal Medicine or Geriatric Medicine

This role is considered patient facing and is part of CenterWell's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Proven track record leading physician groups, including group facilitation, leadership development, team-building, performance management, and driving cultural change

Medical quality and performance improvement experience

Utilization review experience

Preferred Qualifications

Knowledge of Medicaid and Medicare programs

Excellent oral and written communication skills

Good understanding of best practice coding and documentation in value based environment

Additional Information

Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results.

Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.

Accountable: You meet clearly stated expectations and take responsibility for achieving results.

Clinical Knowledge: You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs

Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com