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Network Medical Director

Company: Optum
Location: Tacoma
Posted on: November 11, 2019

Job Description:

Medical Director opening in Tacoma, Washington. This and other physician jobs brought to you by DocCafe.com

JOB DESCRIPTION

Network Medical Director









Department: Administration

Status: Regular, FLSA Exempt

Location: Tacoma, WA

Reports to: Executive Medical Director





JOB SUMMARY

In support of Northwest Physicians Network's (NPN) mission, vision, and strategic goals as an emerging Clinically Integrated Network, the Network AMD is the accountable leader for performance in population health programs across the NPN network. This role provides direction, coordination, support and accountability throughout the NPN network including Primary care practices of various sizes, multispecialty groups, hospitals, and ancillary facilities such as lab, imaging, and post acute care settings. The Network AMD reports of the Network Executive Medical Director. This role supports the Executive Medical Director and Chief Operating Officer regarding all elements of performance throughout the network including adherence to quality performance, timely access for patients, appropriate and accurate documentation and coding, patient engagement, practice engagement with central supports like care management programs provided by NPN, analytic platforms, wrap around care services.



ESSENTIAL DUTIES & RESPONSIBILITIES

The duties listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment.



Medical Leadership

  • Leading and organizing joint operating committees with each contracted entity with a large focus on primary care practices.
  • Sets and implements clear standards and expectations for the professional performance of the providers in the NPN network.
  • Willingness to travel within Washington State on a regular basis as needed (primarily Puget sound area)
  • Chair the credentialing committee
  • Lead onboarding discussions with new practices joining the network (setting appropriate and customized performance expectations in collaboration with the practice)
  • Collaborate with the practice engagement project manager, director of engagement, executive medical director, and leaders within NPN, TEC and Polyclinic to prioritize initiatives and identify the ideal implementation plan for network participants as appropriate.
  • Assists in coordinating efforts between affiliate partners who are part of different organizations (primary care site, and various specialties who are each in different organizations).
  • Assists in the roll out of Optimal Care clinical guidelines where appropriate at the direction of the quality committee.
  • Assists in teaching clinicians and management team about Medicare Risk Adjustment, Star ratings, and overall population health approach to patient care.
  • Align work of Risk Adjustment, Quality, and affordability initiatives internally and translate into ways the affiliate network can actively engage in easily using these resources
  • Willingness to travel within Washington State as needed
  • Collaborate with employed medical groups and affiliate medical groups in a positive way while
  • identifying opportunities for alignment of regional activities (ie. Care management/affordability initiatives, quality initiatives, new care models).
  • Provide secondary assistance in covering Medical Necessity review in Utilization Management
  • Provide secondary assistance in supporting the network development team, discussing with provider groups the value proposition for joining the network.
  • Represent affiliate voice on committees at the request of the Executive Medical Director.
  • Be available when asked, to report to the Quality Committee, Board, Regional Executive committee, or Provider Meetings.
  • Works with the Medical Director for Quality and Safety to support integration of Quality Improvement programs, Daily utilization Management reports, and Disease Management programs.
  • Support patient safety initiatives.
  • Support patient experience initiatives, including patient satisfaction and access.
  • Supports ongoing improvements to the Primary Care Model of care with an emphasis on sustainability, comprehensive primary care delivery, quality performance and patient experience.
  • Collaborate with regional leaders on Care Coordination to understand and support reductions in cost of care through appropriate institutional utilization and resource management by the service line.
  • Assures that utilization of hospital care is appropriate and consistent with well-managed national and regional benchmarks.
  • Assist in planning and implementation of lower cost alternatives to institutional care where appropriate
  • Assure utilization of advanced imaging and prescribing is consistent with national and regional benchmarks.
  • Ensure optimal specialty utilization and appropriate site of service (ASC vs hospital)
  • Help lead the primary care departments to focus on access and reduced inappropriate ER utilization.



    KNOWLEDGE, SKILLS, AND ABILITIES

    • Be flexible and able to quickly customize the conversation with contracted groups at various stages of population health development.
    • Well versed in guiding conversations with clinicians, operations teams, and executive leadership in various organizations.
    • Proven track record of working well with Physicians, ARNP, Physician Assistants, Coders, Schedulers, Managers, Directors and Executives to assure care delivery is patient centered, timely, effective and evidence-based approach to clinical care across all Primary Care and specialty care participants
    • Serves as an ambassador for NPN among network providers
    • Knowledge of managed care, including utilization, care management, quality, credentialing, and peer review
    • Advanced knowledge of Medicare and Medicaid plan design and coverage criteria
    • Ability to analyze problems and formulate plans, solutions, and course of actions
    • Ability to analyze and interpret complex data
    • Ability to research and prepare comprehensive reports
    • Skill in working effectively under deadlines, frequent interruptions and changing priorities[

      MINIMUM QUALIFICATIONS

      Education:

      • Graduate from accredited medical residency program
      • Master's Degree in Business Administration, Hospital Administration or equivalent preferred.

        Experience:

        • 5 years' recent experience in clinical practice
        • 5 years' minimum experience in physician leadership role in medical facility or related environment.



          Certification:

          • Current unrestricted Physician (MD/DO) license for the State of Washington
          • Current driver's license

            EQUIPMENT USED

            Office equipment, computer, personal vehicle



            MENTAL & PHYSICAL DEMANDS/WORKING CONDITIONS



            • Mental Effort: Must be able to work effectively as a member of NPN team; work is detailed and complex with multiple competing priorities, deadlines and internal and external customers

            • Physical Requirements: Work is primarily in office environment requiring ability to see and hear and communicate as well as operate personal motor vehicle

              • Working Conditions: Work is performed both in an office setting and at clinic locations; noise level may be moderate or loud on occasion; work may be required outside normal business hours



                The job description does not constitute a written or implied contract of employment. NPN reserves the right to revise or change job duties and responsibilities as the need arises.

                If any of these skill are not needed please delete.





                Keyphrases: health administration jobs, medical director jobs, hospital administration jobs, hospital administrative jobs, healthcare administration jobs, administration jobs, healthcare administrator jobs, medical administration jobs, chief medical officer jobs, medical director position jobs, associate medical director jobs, medical administrative jobs, healthcare ceo jobs, medical ceo jobs, executive director jobs

Keywords: Optum, Tacoma , Network Medical Director, Executive , Tacoma, Washington

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