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Area Medical Director

Company: Humana Inc.
Location: Pasadena
Posted on: April 8, 2021

Job Description:


Job Description Summary
Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Partners in Primary Care, (PIPC), we want to help people everywhere, including our associates, lead their best lives. At PIPC, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole.

The Area Medical Director serves as a health-care professional and capable of handling a variety of health-related problems. The Area Medical Director requires a solid understanding of how organization capabilities interrelate across multiple clinics/centers.Responsibilities We are excited to share that we are in the process of changing our name to CenterWell Senior Primary Care. We expect our name transition to be complete by the first part of April 2021. We feel our new name will better reflect our commitment to deliver senior-focused primary care and reinforces our commitment to putting patients at the center of what we do every single day. The new name truly captures how we support senior health and wellness from every angle - physical, emotional and social. Join a team committed to making seniors healthier and happier every day by putting them at the center of everything we do.

The Area Medical Director has similar job duties as a Physician, namely focusing on outpatient medicine, continuity of care, health maintenance, and disease prevention. The Area Medical Director is also responsible for administrative oversight and outcomes for clinical providers designated to their area. Keeps a medical history and medical records. Refers the patient to specialists as needed. Decisions are typically related to identifying and resolving complex technical and operational problems within clinics/centers.The Area Medical Director will spend 50% of their time clinically focused on direct patient care, with the remaining time dedicated to administrative duties related to oversight of clinical provision of care in their area.Associate/Area Medical Director (AMD) supports the Regional Medical Director (RMD) in overseeing the Market Clinical-Administrative functions Essential Functions

  • Clinician's PTO management in collaboration with Center administrator, including holiday schedules and as determined by the organization.
  • Management of CME time and reimbursement requests.
  • Service recovery reports (Patient complaints)
  • Guidance to individual clinicians about patient terminations, in collaboration with compliance.
  • Supervise/manage assigned clinicians at site level.
  • Manage behavioral concerns pertaining to assigned clinicians
  • Provider on-boarding as determined by on boarding procedure.
  • Provider off-boarding as determined by off boarding procedure.
  • Provide support to on site clinicians with logjams and workflow issues.
  • Check in with clinicians at their site routinely.
  • Oversight of provider quality and development of workflows to help close gaps in quality
  • Schedule at least one half day at clinic site for onsite visit per week
  • Support clinicians with schedule templates, coverage, daily issues
  • Assist with panel management
  • Oversight of quality of assigned team members
  • Meet with Regional CAs and other AMD at least monthly
  • May be assigned to organizational committees as needed, to attend and represent the clinical perspective of the market
  • Assist in Ongoing Chart Review monitoring
  • Assist with recruitment and interviewing as requested.
  • Desktop coverage as necessary
  • In collaboration with RMD, complete performance reviews as required (90 day, yearly, etc.).
  • Serve as a mentor to help guide clinicians as needed
  • Participate as backup on call
  • Lead all provider monthly meeting if RMD is not available, with adequate notice from RMD to allow for preparation.
  • Assist in organizing team building activities
  • Maintain regular clinic hours for a percentage of FTE as determined with Regional Medical Director, as detailed on the clinical job description.
  • Serve as a community representative for CenterWell in media and press activities
  • May involve supervision of mid-level providers
  • Performs other duties as assigned.Required Qualifications
    • Current and unrestricted medical license in Texas or willing to obtain a medical license in Texas prior to employment, and eligible and willing to obtain licenses in other states in the region of assignment, as required
    • Graduate of accredited MD or DO program of accredited university
    • Board Certification or True Board Eligibility in Family Medicine, Internal Medicine or Geriatric Medicine with continued certification throughout employment
    • Excellent verbal and written communication skills
    • Demonstrate a high level of skill with interpersonal relationships and communications with colleagues/patients
    • Fully engaged in the concept of "Integrated team based care" model
    • Willingness and ability to learn/adapt to practice in a value based care setting
    • Superior patient/customer service
    • Basic computer skills, including email and EMR
    • This role is considered patient facing and is a part of Partners' Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB Preferred Qualifications
      • Active and unrestricted DEA license
      • Medicare Provider Number
      • Medicaid Provider Number
      • Minimum of two to five years directly applicable experience preferred
      • Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value based relationship environment.
      • Knowledge of Medicare guidelines and coverage.
      • Knowledge of HEDIS quality indicators
      • Bilingual English/Spanish.-- Must be able to speak, read and write in both languages without limitations or assistance. See Additional Information on testingAdditional InformationLanguage Proficiency TestingAny Partners associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.#physiciancareersScheduled Weekly Hours40

Keywords: Humana Inc., Pasadena , Area Medical Director, Healthcare , Pasadena, California

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