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SalaryJob Summary
The Associate Medical Director is an integral member of the Health Services team working in conjunction with the Chief Medical Officer. The Associate Medical Director contributes to the overall success of the Company by ensuring the highest standards of provider guidance, patient care and regulatory compliance. The Associate Medical Director works closely with Health Services and Operations leadership on issues related to provider relations, medical quality, and optimizing the utilization of the Company's services and resources.
Essential Job Functions
- Performs utilization and quality analysis as it pertains to market, groups and PCP to determine trends that impact financials.
- Works with Operations and Provider Representatives in their monthly PCP meetings to provide insight and back up as it pertains to continuous improvement plans.
- Monitors and evaluates admissions, discharges and ER visits to identify transitional care follow up office visits.
- Assists with Case Management to identify appropriate utilization of post-discharge and chronic disease patients.
- Communicates with PCP when necessary to investigate practice performance and its correlation to key performance indicators and practice improvement plans.
- Coordinates and addresses medical grievances from providers, and coordinate solutions with the team and Medical Plan.
- Engages in conflict resolution as it relates to grievances, performance and or practice issues related to patient care.
- Trains PCPs regarding MRA, HEDIS, ACP program and software utilization.
- Other duties as assigned.
Knowledge, Skills and Competencies
- This position requires a dynamic individual with a strong background in healthcare leadership, policy development and execution as well as relationship management.
- Strong understanding of utilization management as well as standard utilization and financial metrics.
- Strong ability to analyze utilization and communicate with providers regarding gaps in care and provide suggestions and solutions.
- Familiarity with accountable care organizations, concepts and goals.
- Strong understanding of population health management and the ability to apply concepts to physician practice improvement.
- Strong ability to communicate provider performance based on ilumed measurements and identify opportunities to consider change.
- Able to relate cooperatively and constructively with patients, families, and co-workers.
- Ability to communicate verbally and in writing.
- Maintains confidentiality of sensitive information.
- Ability to problem solve to formulate a plan of care and evaluate the patient's response to care.
- Ability to interpret, adapt, and react calmly under stressful conditions
- Ability to manage multiple projects and conflicting priorities.
- Microsoft Office including Word, Excel and PowerPoint
Education and Experience
- Doctor of Medicine or Doctor of Osteopathy from an accredited medical school
- MD - Doctor of Medicine Current state medical license and in good standing with medical board
- 5 years in primary care, family medicine, or comparable specialty
- 2-3 years of medical Director or similar leadership experience in primary care.
- Experience with data analytics programs and reporting.
- Experience in practice transformation as it pertains to the Triple Aim
Physical Requirements
- Prolonged periods of sitting at a desk and working on a computer.
Additional Information
- Must abide by all HIPAA, Confidentiality & Privacy Laws
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.
- Must be able to travel up to 25%
DISCLAIMER:
Job descriptions are not meant to be all-inclusive and/or the job itself is subject to change. Nothing in this job description restricts ilumed’s right to assign or reassign duties and responsibilities to this job at any time.
