ACO Regional Medical Director

At CareConnectMD, we are guided by our values of compassion, dedication and excellence. We strive to be present for our patients and their families at every step of the way, recognizing that our healthcare system is challenging to navigate through. We partner with primary care groups who manage Medicare beneficiaries who are attributed to our two ACO programs: the High Needs Accountable Care Organization, Realizing Equity, Access, and Community Health (REACH) and the Medicare Shared Savings Program (MSSP).

Key Duties And Responsibilities

Under the direction of the Chief Medical Officer and in close collaboration with operational leaders, the ACO Medical Director will be responsible for working with participating providers and preferred providers on initiatives focused on improving patient outcomes via a high touch program. The ACO Medical Director will engage with patients and their families, goals of care discussion, working closely with the case management team thereby reducing medically unnecessary utilization, and managing healthcare costs. Additionally, the ACO Medical Director will also be responsible for market creation, maintenance and growth of the ACO population.

Essential Duties:

• Works closely with Chief Medical Officer in the development, implementation, and monitoring of clinical standards.
• Understands the CareConnectMD clinical model including high touch interventions, family engagement, transitions of care post ER/hospital discharge, goals of care discussion and close patient monitoring
• Educate and implements the clinical model in each market by collaborates closely with each provider partner, understanding each market infrastructure and adapting the model to it
• Working closely with each provider partner group on clinical collaboration reviewing patients and providing recommendations to improve patient outcomes based on the clinical model
• Review patients’ charts for high-risk patients and provides visits as medically necessary, coordinating care with the case management team, primary care clinicians, specialists, hospice, home health.
• Guides the case management team with individualized care plan and ensure execution
• Reviews utilization metrics with partner provider accounts to achieve meaningful quality improvements and reduce unnecessary health care utilization by keeping partner provider engaged and motivated
• Leads Joint Operating Committees meetings (JOC), Quarterly Business Review meetings (QBR) to review performance and guide changes
• Works with quality management staff to enable quality reporting to ensure performance reporting as required by ACO.
• Ensuring compliance with documentation accuracy and completeness
• Complete comprehensive annual wellness evaluations and visits for traditional Medicare beneficiaries enrolled in the ACO program, as needed.
• Understands key performance indicators (KPIs) and financial operational metrics in the High Needs ACO REACH and MSSP and assists in activities to improve them.
• Participates and provides reports to ACO leadership, as required.
• Available resources to participant providers and helps in the investigation and response to various complaints or grievances against individual participant providers, the HN ACO REACH or the MSSP Program.
• Builds a team, resolves conflicts, and facilitates group interaction both within the team and with cross-departmental teams.
• Collaborate with business development team to assist in attributing patients into program, discuss/advise partner providers in retaining patients in program and contribute to growth plan.
• Complies with and promotes adherence to applicable legal requirements, standards, policies and procedures including but not limited to those within the HN ACO REACH and MSSP Compliance Process, Standard/Code of Conduct, Federal False Claims Act and HIPAA.
• Ensures timely and accurate reporting and responses to compliance-related issues and monitors the implementation of corrective action plans related to such issues.
• Travel to ACO markets in various states, as needed.
• Performs other responsibilities as assigned.
  
  
  

Education And Experience

• A licensed physician in residing state.
• Currently holds a board certification in a primary care specialty (Family Medicine, Internal Medicine, Geriatrics).
• Three (3) years of medical group management/leadership experience is strongly preferred.
• Current or previous SNF/LTC Medical Director experience or in working in other long-term care settings like Skilled Nursing Facilities, Assisted Living Facilities, Board and Care.
• Familiar with concepts of palliative care.
• Experience working in an integrated delivery system, Managed Care, Value-based care or ACO
• Experience in anticipating and responding to the needs of internal and external customers.
  
  
  

Essential Skills And Abilities

• Excellent human relations, organizational and communication skills.
• Proven track record of driving successful performance outcomes and accomplishing organizational goals.
• Skills in building partnership with management, staff, and stakeholders.
• Skill in utilizing data and information to make informed and appropriate decisions.
• Passionate about continuously improving and providing high quality, efficient care and excellent service, to patients, families, employees, physicians, providers and clients.
• Thrives in an start-up environment.
• Self-starter that can work independently and collaboratively, prioritize tasks and has initiative and excitement to take on unfamiliar tasks.
• Creative, flexible, well organized, resourceful, and detail-oriented.
• Excellent judgment in handling confidential and sensitive information.
• Comfortable working with a multidisciplinary clinical team - NPs, PAs, pharmacists, nurses, social workers, case managers, site administrators.
• Ability to work independently, set priorities and handle multiple tasks with a high level of efficiency.
• Establishing and maintaining cooperative working relationships with others.
• Ability to work across locations and time zones.
• Lift up to 10 pounds frequently, and/or up to 25 pounds occasionally.
• Must have sufficient visual acuity to work.
  
  
  

Core Competencies

• Instills trust
• Customer focus
• Manages ambiguity
• Collaborates
• Drives results
  
  
  

Geography for this role will be CA, FL, NY, MI, NE, TX.

To ensure the health and safety of our workforce while doing our part to protect those around us, CareConnectMD is requiring proof of full COVID vaccination for employees as a condition of employment, subject to legally recognized accommodations.