"Alerted.org

Job Summary and Responsibilities

***This position will be hybrid work from home and onsite** **within California** **, requiring up to 50% travel throughout California.

Position Summary:

The Medical Director is responsible for overseeing the development, implementation, and continuous improvement of clinical strategy across the Value Hub. They serve a pivotal role that requires a deep understanding of clinical operations, healthcare management, and collaborative leadership. The Medical Director works closely with network participants to ensure that care delivery and clinical operations meet the highest standards of quality, efficiency, and patient satisfaction. They provide strategic oversight to the Value Hub Operations and serve a leadership role in Value Hub governance. They are critical is driving CommonSpirit's Population Health strategy and growing Value Based Care in the region.

Essential Functions include:

Leadership

- Participates as an active leader of the Regional Value Hub leadership team.

- Drives strategic alignment across the Regional Value Hub, with CommonSpirit Health’s Population Health strategy and Value Based Care goals.

- Serves as clinical advisor and leader in interactions with health plans, employers, and network participating providers.

- Provide direct oversight to other market or regional Medical Directors in the Value Hub

- Leads the development and execution of clinical strategies and initiatives to improve patient care and operational efficiency.

- Fosters strong relationships with both employed and independent providers to ensure ongoing collaboration and alignment.

- Serves as the chair of the Value Hub Governance Committee, organizing leaders within the region to provide oversight, decision-making, and standardization for strategy and operations.

- Guides and support network operations professionals, fostering a culture of continuous improvement and innovation.

- Provides clinical and strategic guidance to operational teams as directed in activities according to the needs, requirements, and policies of the local markets, the affiliated medical groups and health plans, CommonSpirit Health, any Federal and State agencies.

- Works closely with all departments along the care continuum and service providers to enhance the patient experience through the health care system.

- Keeps the organization’s mission, vision and values at the forefront of associate decision-making and action.

- Interacts with others in a way that gives them confidence in one’s intentions and those of the organization.

- Demonstrates breadth and/or depth of professional/technical skills and capabilities required for position; shares knowledge; sets or contributes to CommonSpirit Health’s direction within area of expertise.

- Collaboratively problem-solve with medical staff, Practice Managers, Directors, and other regional Medical Directors.

- Facilitate effective communication between staff and leadership to ensure alignment and address concerns.

Operations

- Lead clinical strategy and initiatives in partnership with the National PHSO, interacting with Value Hub operations, practice managers, and the market providers to promote clinical excellence and operational efficiency.

- Support development and implementation of quality improvement initiatives, providing education and engagement with Physicians, to drive performance and outcomes

- Oversee and mitigate issues with physician performance, including patient satisfaction, performance management, and behavioral refinement.

- Address escalated provider or patient complaints

- Collaborate with network providers to develop and implement strategies for improving patient outcomes and reducing variability in care.

- Build strong relationships to increase participation and partnership with independent physicians

- Collaborate with legal and compliance teams to address regulatory and compliance issues as needed

- Serve as a clinical advisor and participate in strategic planning for the networks, focused on enhancing performance, identifying growth opportunities, providing the clinical perspective on new contractual arrangements as needed.

- Support major initiatives (e.g., platform implementations, strategic transformations) as the clinical advisor for the Regional Value Hub.

Quality / Outcomes

- Partners with PHSO Quality and Risk team and Value Hub leadership to formulate and implement strategies for achieving applicable metrics.

- Advises on department performance including: setting goals, monitoring performance progress, providing feedback, recognizing and addressing performance issues

- Ensures that the patient and provider perspectives are a driving force behind department actions and business decisions; constructing and implementing service practices that meet patients'/customers and own organization’s needs. (Focus also includes internal and external customers.)

- Supports for accreditation surveys using the appropriate standards of performance. Ensures compliance with DMHC/CMS/NCQA/state/local healthcare related laws, regulations and accreditation standards.

- Serves on teams engaged in the development and updating of policies, procedures, workflows, tools and action plans recommends, implements and evaluates new/revised standards, policies, procedures, guidelines to ensure consistency with the philosophy/values of the organization and compliance with applicable regulatory/accreditation requirements; ensures that all functional activities are fully documented in accordance with the standards and practices of the organization.

Job Requirements

Minimum Qualifications:

- 5 years of clinical practice

- 5-7 years of experience in provider network, clinical or hospital setting.

- Medical degree (MD or DO) from an accredited institution

- Current MD/DO license to practice medicine within the State of California; Board Certification in a relevant specialty

- Experience in building and maintaining physician relationships and partnerships

- A deep understanding of the health industry.

- Strong communication skills

Preferred Qualifications:

- Experience in value-based care and/or population health strongly preferred.

- Payer relationship experience preferred.

- CMS knowledge preferred.

Where You'll Work

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

One Community. One Mission. One California (https://youtu.be/RrPuiSnALJY?si=pvQgPZ6ZWZM60TPV)

Pay Range

$118.62 - $176.44 /hour

We are an equal opportunity/affirmative action employer.