The Chief Medical Director HMHP serves as the executive clinical lead for the Population Health Division, managing partnerships with Health Systems, Physicians, Payers and vendors. The Chief Medical Director HMHP collaborates with multiple stakeholders to provide clinical and population health management expertise and leadership, with a specific focus on Physician leadership/engagement, clinical practice transformation and care delivery model design and execution.
Education, Knowledge, Skills and Abilities Required: 1. Minimum of five years successful clinical practice experience. 2. Minimum of three years risk experience with exposure to: disease management, HEDIS reporting, provider relations, utilization management, quality management, peer review, case management, denial/appeals, and accreditation. 3. Knowledge of healthcare financing and the relation to various managed care products (HMO, PPO, Indemnity, and Medicare Advantage). 4. Knowledge of continuous quality improvement theory and practice. 5. Excellent communication and problem-solving skills. 6. Demonstrated track record of building productive working relationships with subordinates, peers, senior management, and external partners. 7. High level of energy and drive. Education, Knowledge, Skills and Abilities Preferred: 1. Government sector experience (Medicare or Medicaid products) Licenses and Certifications Required: 1. MD. or D.O. degree, plus Board Certification. 2. Current, unrestricted medical license. Licenses and Certifications Preferred:
1. Provide clinical leadership in the development, organization and leadership of a clinically integrated network (CIN) of physicians. 2. Manage CIN Regional and Associate Medical Directors. 3. Participate in business development meetings with physicians to present the value proposition of participating in the CIN. 4. Strategize on clinical strategy, design and approach, facilitating communications, and managing risk. 5. Collaborate on clinical program development, implementation and operations. 6. Provide support to CIN on matters relating to accountable care, physician engagement/alignment, payer and clinical transformation. 7. Direct and monitor medical management activities and quality management programs as needed to maintain compliance with CMS, managed care agreements, and accrediting bodies. 8. Act as a Liaison between CIN and Employed HMH practices. 9. Other duties and/or projects as assigned. 10. Adheres to HMH Organizational competencies and standards of behavior. 11. Lifts a minimum of 5 lbs., pushes and pulls a minimum of 5 lbs. and stands a minimum of 1 hour a day.