Executive Medical Director - Value Based Care

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Job Summary

This position is responsible for strategic physician leadership to support market strategy, implementation, and operations of value-based care (VBC) programs and initiatives. This position shall coordinate across the Plan and broadly across HCSC to develop effective population health strategies that target reductions in unnecessary medical utilization and improve clinical quality and healthcare outcomes. This position is responsible for external facing responsibilities and maintaining effective relationships with providers, clients, and the community. As a people leader, this position is responsible for leading the clinical support teams for our accountable care organizations and employer clinical teams. In addition, to various degrees, this position will respond to and resolve problems, serving as the final decision maker for clinical determination. This position will also head projects to promote effective medical policy relative to the membership of these major accounts. In addition, to various degrees, this position will perform physician level review using applicable systems and maintain effective relationships with physicians, hospitals, and medical service companies to respond to and resolve problems, serving as the final decision maker for clinical determination. This position will also head projects to promote effective medical policy relative to the membership of these major accounts.

JOB REQUIREMENTS:

• Physician (M.D. or D.O) with a current and unrestricted physician license in a state or territory of the United States
• Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists
• 5 years of post-graduate patient care/clinical experience. 5 years of managed care experience coupled with proven experience in the application of medical problems to managed care practices.
• Knowledge of current medical and surgical techniques, reimbursement methodology, and benefit management.
• Leadership skills to lead groups to consensus and resolution building aligned to corporate strategy
• Demonstrated ability to independently make tough strategic decisions and move forward with actions on the strategies.
• Strong verbal and written communication skills.
• Experience achieving results through people.
• Experience being proactive and highly results oriented; able to meet deadlines under pressure.
• Experience thinking innovatively and developing process improvements to align with business strategies.
• Experience being the subject matter expert/leader in a specified field.
• Experience presenting and negotiating.
• Strategic thinking skills.
• Proficiency in computer use (including software applications such as Microsoft Office Product, (Lotus Notes) needed for electronic documentation of case reviews
• Please note, this is a hybrid role which requires 3 days in-office hours a week
  
  

PREFERRED EXPERIENCE:

• Alternative Payment Models and Value Based Care strategies, contracting, and innovation
• Knowledge or experience in Payment Integrity a plus
  
  

- AZ1

- Hybrid

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HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

$205,500.00 - $381,600.00