Medical Practice Oversight:
Serve as the Regional Medical Director for assigned DTCs, overseeing medical care and providing direct supervision for care delivered by the interdisciplinary team.
Develop and supervise the delivery of ambulatory medical services.
Act as the primary medical resource for site directors and the interdisciplinary team.
Balance evidence-based medicine with patient conditions and values to optimize care outcomes.
Provider Operations:
Ensure adequate provider staffing and coverage for all sites.
Lead performance appraisal and professional development activities for providers.
Recruit, hire, and onboard new providers, managing call schedules to ensure coverage.
Review and update policies and procedures annually to maintain high care standards.
Participate in committees as assigned by the CMO.
Outcomes Management:
Identify opportunities to improve care quality and lead program development initiatives.
Supervise the sites’ Quality Assurance Performance Improvement (QAPI) program.
Monitor provider performance related to quality, cost, and utilization.
Ensure a patient-centered approach in care programs and services.
Clinical Coverage and Collaboration:
Provide clinical coverage for episodic care and participate in care planning as needed.
Build collaborative relationships with interdisciplinary team members and leadership.
Serve as a liaison with medical organizations and community practices as necessary.
Lead initiatives to improve care under the direction of the CMO.
Managed Care and Clinical Design:
Support clinical review activities and participate in the appeals and grievances process.
Conduct chart reviews and engage in peer-to-peer discussions to validate medical necessity.
Use data analytics to develop targeted interventions and improve care for high-risk members.
Apply quality improvement principles (e.g., PDSA) to ensure effective care delivery.
Participate in registry management and peer review activities to uphold high standards for quality, safety, and cost-effectiveness.
Experience & Skills Required
Minimum of 3 years of experience in staff supervision and managing provider groups.
Experience in value-based organizations, advanced primary care, or managed care.
Strong sensitivity to operational needs and patient-centered care.
At least 1 year of experience working with frail or elderly populations, or appropriate training upon hiring.
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