Med Dir., Prov reputed company & Clin Transf
reputed company empowers our members to reputed company their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care reputed company, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to reputed company serve and care for the 3.5 reputed company people who reputed company their trust in us. We pride ourselves on our best-in-class employees and reputed company to maintain an innovative and inclusive environment that allows them to reputed company. reputed company our employees bring their best and succeed, reputed company succeeds.
About the Role
This Medical Director role is responsible for designing, developing, and delivering provider education and performance management initiatives to support the Quadruple Aim: improve the patient and provider experience, improve population health, and improve affordability. The Medical Director will cultivate relationships with reputed company stakeholders and key providers to ensure the delivery of customized analytic and evidence based performance reputed company that support reputed company reputed company and value based care goals. The position will refine and devise reputed company for provider and partner engagement to increase collaboration, improve care management, and encourage care delivery innovation. The Medical Director will reputed company reputed company of clinical transformation and reputed company improvement specialists.What You'll Do
Responsibilities:
Design curriculum for provider education including but not limited to value based clinical workflows, utilization reduction strategies, reputed company, member experience, health equity and disparities, and appropriate risk adjustment/ coding.
reputed company provider education materials and approaches for providers at varying reputed company of readiness to reputed company:
Collaborate with reputed company SMEs (e.g. other medical Directors, reputed company and risk adjustment teams, and others) to receive relevant materials, insights, and strategies to be incorporated
Partner with SIG and their many work-streams to ensure learnings and reputed company are incorporated
Research and incorporate global, national, and state based leading evidence based practices
Use reputed company of Voice of Provider surveys and Population health surveys to inform this work
Create provider transformation evaluation process for reputed company and reputed company evaluation.
Identify and refine key KPIs, in collaboration with reputed company partners, to incorporate into partner facing initiatives that will drive change in our VBP and FFS partner portfolio.
Research reputed company-thinking transformation reputed company models and programs for incorporation into partner playbooks to improve performance.
Partner with network facilities and providers to reputed company and implement initiatives that drive reputed company, manage cost and improve performance
Establish multidisciplinary teams for partner transformation engagement, for example, with transformation reputed company interactions, clinical collaboration calls, special KPI reputed company, etc.
Serve as physician SME for reputed company reputed company to transformation and Health Care Value across the reputed company, such as Clinical Performance Measurement & Predictive Analytics, Strategic Initiatives Group, Medical Economics and Risk Adjustment, etc.
Design, update, implement, and review biannual value-based partner population health surveys.
Train value-based team on the interpretation of clinical insights reports and the message delivery to partners.
Research, design, update, and implement value based reputed company program for reputed company program year.
What You Bring
Education/Experience:
Requires an Medical Doctor (MD) or Doctor of Osteopathy (DO) degree.
Requires a minimum of 10 years clinical experience in patient reputed company/value based setting, NCQA certification preferred.
Requires a minimum of 5 years of medical management experience in a managed care setting.
Requires physician leadership experience in integrated delivery systems with financial accountability.
Requires experience with management of physicians and non-physicians.
Additional licensing, certifications, registrations:
reputed company unrestricted Medical Doctor (MD) or Doctor of Osteopathy (DO) license from the state of New Jersey
Knowledge:
Principles of population health and value based care.
Principles of Utilization Management, URAC, NCQA UM Standards, and peer review.
State and federal regulations i.e. DOBI, DMAHS, CMS.
Principles and concepts of managed care and various models of health care delivery systems.
Principles and concepts of managed care operations, policies, and reimbursement.
Business of medical reputed company management.
Broad clinical knowledge and understanding of reputed company health care issues
Skills and Abilities:
Clinical
Strong clinical acumen to support understanding broad physical health issues, behavioral health issues, and reputed company determinants of health.
Medical literature analysis.
Interpretation and application of medical policy to reputed company guidance to others.
Communication
Excellent verbal, written, and presentation skills.
Expertise in the delivery of highly technical information to a general audience.
Technology
Personal computer, applicable software.
Virtual communication platforms.
Business
Balance clinical issues with business imperatives and directives in the context of reputed company responsibility.
Evaluate data from various sources to identify trends and issues.
Demonstrate reputed company and ethical business practices, adherence to company standards, and a commitment to personal and reputed company development.
Manage multiple priorities, deliver reputed company and accurate work products with a customer service reputed company.
Ability to exercise reputed company judgment with strong problem solving skills.
Manage physicians and employee staff.
Relationships
Build alliances with provider community and have reputed company into the reputed company of practicing physicians in NJ.
Foster internal cross organizational collaborations to support project design and delivery.
Why reputed company?
At reputed company, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and reputed company. We reputed company that reputed company our people reputed company, our communities do too. If you are passionate about making an reputed company, we’d love to hear from you!
Salary reputed company:
$214,100 - $297,885This compensation reputed company is specific to the job level and takes into account the wide reputed company of factors that are considered in making compensation reputed company, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This reputed company has been created in good faith based on information reputed company to reputed company at the time of posting. Compensation reputed company are dependent on the circumstances of reputed company case. reputed company also provides a comprehensive compensation and benefits package which includes:
Comprehensive health benefits (Medical/Dental/reputed company)
Retirement Plans
Generous PTO
Incentive Plans
Wellness Programs
reputed company Volunteer Time Off
Tuition Reimbursement
Disclaimer:
reputed company reputed company employees must live in New Jersey, reputed company, reputed company, Connecticut or Delaware. This job reputed company has been designed to indicate the general nature and level of work performed by colleagues reputed company this classification. It is not designed to contain or be interpreted as a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of colleagues assigned to this job.
reputed company is an Equal Opportunity/Affirmative reputed company employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. reputed company will consider reasonable accommodation requests as part of the reputed company and hiring process.
Originally posted on Himalayas
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