Senior Medical Director

Description

We are seeking a hands-on Senior Medical Director to drive clinical and operational excellence, with specific focus on risk score optimization, patient visit volume, and quality outcomes. This role requires a leader who can implement and scale programs that directly impact patient care quality while managing the financial aspects of value-based contracts.

Requirements

Key Responsibilities

Risk Score Optimization & Clinical Quality (50%)

• Program Development: Design and implement risk adjustment programs to accurately identify and document patient conditions.
• Increase Patient Visits: Develop strategies to support ptx visit completion rates/improve access to care.
• Documentation Improvement: Lead initiatives to enhance clinical documentation/coding accuracy.
• Provider Education: Educate providers on proper diagnostic coding and documentation practices.
• Performance Metrics: Establish and monitor metrics to track risk score performance.
• Wellness Programs: Drive implementation of annual wellness visits and chronic care management.

Network Management & Care Model Implementation (30%)

• Referral Optimization: Streamline referrals to high-performing specialists and ancillary providers.
• Partnerships: Build and maintain strong relationships with key network partners.
• Leakage Reduction: Monitor and reduce network leakage, keeping patients within network services.
• Care Coordination: Implement protocols between primary care/specialists for seamless ptx transitions.
• Quality Gap Closure: Identify and address quality gaps through our care model application.

Operational Leadership (20%)

• Clinical Oversight: Supervise Northern region clinics, ensuring operational efficiency and adherence to SEMG standards.
• On-Site Engagement: Regular presence at clinics (up to 50% travel) to engage teams and address challenges.
• Leadership: Chair Clinical Advisory Committee and mentor medical directors and lead physicians.
• Collaboration: Partner with Population Health team to execute value-based programs.
• Performance Monitoring: Optimize clinical/financial performance metrics to achieve SEMG goals.

Qualifications

• MD or DO in Family Practice or Internal Medicine.
• Active medical license in Georgia (Alabama and Tennessee preferred).
• 5 years in a senior physician leadership role.
• Demonstrated success in value-based care, risk-bearing provider groups, and population health management.
• Operational expertise in large, matrixed healthcare environments.
• Knowledge of CMS Risk Adjustment, ICD-10 coding, federal/state laws, and NCQA regulations.
• Proven ability to implement and scale value-based care models.
• Strong data analysis and decision-making abilities.
• Excellence in physician engagement and change management.
• Exceptional interpersonal and communication skills.

Key physical and mental requirements:

• Ability to lift up to 50 pounds
• Ability to push or pull heavy objects using up to 50 pounds of force
• Ability to sit for extended periods of time
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for simple and complex problem solving
• Ability to travel to multiple work sites as needed

FLSA Classification: Exempt

Southeast Primary Care Partners is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

12/2024

Salary : $275,000 - $375,000