Description
The Medical Director of Value Based Care will lead strategic clinical initiatives to optimize performance and outcomes within Southeast Primary Care Partners’ networks. This role will embed clinical best practices, drive quality and utilization improvements, and foster collaboration among providers and network leaders. The position reports directly to the Chief of Development and works closely with regional medical directors, IPA / MSSP boards, and various committees to advance the organization’s value-based care objectives.
Requirements
Reports to : Chief of Development
FLSA Status : Exempt
I. Position Summary
The Medical Director of Value Based Care will lead strategic clinical initiatives to optimize performance and outcomes within Southeast Primary Care Partners’ networks. This role will embed clinical best practices, drive quality and utilization improvements, and foster collaboration among providers and network leaders. The position reports directly to the Chief of Development and works closely with regional medical directors, IPA / MSSP boards, and various committees to advance the organization’s value-based care objectives.
II. Essential Duties and Responsibilities
Clinical Leadership and Guidance
- Provide medical oversight for improving documentation and Hierarchical Condition Category (HCC) coding to accurately reflect the burden of illness.
- Collaborate with network leadership to increase gap closure rates, enhance quality metric performance, improve patient satisfaction, and reduce unnecessary utilization.
Performance Evaluation
Evaluate individual practice performance related to clinical documentation and coding accuracy.Conduct operational reviews of underperforming practices, develop remediation plans, and recommend further actions as needed.Committee and Board Participation
Attend IPA and / or MSSP board and committee meetings, either in person or virtually, to present clinical insights and strategize quality initiatives.Proactively contribute to board decisions regarding policy development and best practices in value-based care.Quality Improvement and Utilization Management
In partnership with regional medical directors, establish quality improvement and utilization management standards, policies, and procedures.Monitor and analyze clinical outcomes to inform continuous improvement strategies.Physician Liaison and Leadership
Serve as a spokesperson and liaison between network leaders and participating practices.Act as a member of Southeast Primary Care Partners’ Physician Leadership Team, playing a key role in shaping strategic initiatives and organizational goals.III. Qualifications and Requirements
Education and Experience
Medical degree (MD or DO) from an accredited institution.Current, valid medical license to practice in the relevant state(s).Minimum of 5 years of clinical practice experience, with proven leadership roles in healthcare organizations.Experience with value-based care or population health management, including capitation models, risk contracting, or accountable care organizations (ACOs).Knowledge, Skills, and Abilities
Deep understanding of quality metrics (e.g., HEDIS), HCC coding, and healthcare reimbursement methodologies.Demonstrated experience in analyzing practice performance data, identifying trends, and developing targeted improvement plans.Excellent communication and interpersonal skills, capable of motivating teams and building consensus.Ability to handle confidential information with discretion and comply with all HIPAA and corporate compliance regulations.Strong organizational and time management abilities to balance multiple responsibilities effectively.FLSA and OSHA Considerations
This position is classified as Exempt under the Fair Labor Standards Act (FLSA) due to its professional, executive, and administrative nature.Responsible for knowledge of and compliance with all relevant OSHA standards, ensuring a safe working environment.IV. Working Conditions and Physical Demands
Primarily operates within an office or clinical environment.Periodic travel to practice locations, board meetings, and conferences.Continued readiness to perform and complete tasks in a fast-paced healthcare setting.V. Other Duties
This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this position. Duties, responsibilities, and activities may change at any time with or without notice.VI. Equal Opportunity Employer Statement
Southeast Primary Care Partners is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, genetic information, or any other protected status in accordance with applicable federal, state, and local laws.
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