Associate Medical Director

Company: Association of Clinicians for the Underserved
Location: San Bruno
Posted on: February 16, 2021

Job Description:

As part of the physician leadership team, assisting the Regional Medical Director or Senior Medical Officer (SMO), the Associate Medical Director (AMD) provides clinical and operational oversight to a team of physicians and advanced level practitioners, and acts as a leader for the interdisciplinary team accountable for serving a patient population and/or geography within a Landmark market. The AMD directs and helps build the capacity of a team of providers to manage a population of complex patients, and is responsible for achieving clinical outcomes, optimizing utilization/costs, ensuring high patient satisfaction, managing local community partner relationships, and contributing to productive health plan relationships. This position is 60-70% administrative, and 30-40% clinical/direct patient care.-- --- Partner with the clinical operations team to drive Landmark value lever outcomes across a large patient population.
--- Supervise zone medical directors (ZMDs), POD leaders and advanced practice practitioners, including overseeing provider education, development and formal/informal feedback, in-service training, and orientation.
--- In partnership with other market managers, act as a clinical leader across the interdisciplinary team (IDT). Resolve conflicts among team members. Ensure adherence and accountability to Landmark protocols (e.g. huddles), processes and outcome metrics. Ensure communication across all market PODs are coordinated with MLT team.
--- Lead effective interdisciplinary team meetings, including case reviews that engage the full team, teaching on relevant clinical topics, and training on new protocols and workflows.
--- Act as a local leader and advocate for the Landmark model with community providers and delivery systems and other community partners or potential business partners.
--- Assist in the development of materials and presentations for external meetings, including PCP and delivery system meetings or health plan Joint Operating Committees (JOCs).
--- Stand in for RMD/SMO when not available for meetings within and outside of Landmark.
--- Assist with creating, publishing and participating in the call schedule, approving PTO and other administrative activities.
--- Assist in the development of, documentation, implementation, and interpretation of local medical policies and procedures.
--- Collaborate with the Program Director, VP of Medical Services and other Landmark Health management regarding local issues including patient care plans and authorizations for service.
--- Remain current in the knowledge of geriatrics, utilization management, quality management, managed care principals and new clinical developments and technologies.
--- Take an active role in reviewing and discussing all items pertaining to Utilization Management. At the direction of the RMD/SMO, the AMD may be responsible for oversight of the Utilization Management process. This includes, but is not limited to the following: o Referral request determinations
o Medical Necessity Denial of requests (with consultation with a specialist as needed)
o Acting as Chairperson of the Utilization Management Committee and the Quality Improvement Committee (if unable to attend, then Medical Director will arrange for his/her "designee" to perform this responsibility)
o Review of policy and procedures
o Direct communication with individual providers regarding UM decisions --- Assist in the development, implementation, and evaluation of the market's Quality Improvement Program and participates in the continuous assessment and improvement of the quality of care provided to members.
--- At the direction of the RMD/SMO participates in the resolution of medically related grievances.
--- Participate in recruitment of new providers and, at the direction of the RMD/SMO, reviews and makes recommendations to the Credentialing Committee regarding the appointment and re-appointment of panel providers.
--- Participate actively in the management of provider's contract status within the provider panel to ensure the delivery of quality-based health care while supporting the protections of the provider's rights as well as Landmark Health's obligations for oversight and reporting.
--- Participate in Medical Director Conferences if approved.
--- Participate actively in all Peer Review activities. --- Other duties as assigned by the RMD/SMO.
--- Medical Doctor currently licensed to practice without restriction in the state of practice and has met or exceeded all the credentialing requirements of a provider within the provider panel.
--- Current in the knowledge of geriatrics, utilization management, quality management, managed care principals and new clinical developments and technologies.
--- Have significant experience in leading teams of physicians and mid-level providers in delivering high quality, cost effective care.
--- Experience in recruiting and hiring medical talent along with continuous supervision of the medical care delivered.
--- Ability to analyze staffing needs sufficient to care for the patient panel.
--- Experience in coaching members of the health care team to provide excellent care or, if needed, determine deficiencies in care and formulate a plan for improvement.
--- Access to reliable transportation to conduct patient visits required. --- Must be board certified at the time of hire or able to obtain board certification during the eligible timeframe (5 years following completion of residency or other training) 1420 Spring Hill Road
Suite 600
McLean, VA 22102

Keywords: Association of Clinicians for the Underserved, San Bruno , Associate Medical Director, Executive , San Bruno, California