Description
CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, Missouri, Nevada, North Carolina, South Carolina and Texas. CenterWell Senior Primary Care has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary care combined with an excellent patient experience. CenterWell Senior Primary Care has experience in both the treatment and management of most chronic and acute-care conditions. The practices also provide health education and value-added, well-being services at the centers and around their neighborhoods to help both patients and community members improve their health.
At CenterWell Senior Primary Care, we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all.
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
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
* Clinicians 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 Senior Primary Care 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 CenterWell Senior Primary Care's 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
Additional Information
physiciancareers
Scheduled Weekly Hours
40
Louisville, KY
Humana Inc., together with its subsidiaries, operates as a health and well-being company in the United States. The company offers medical and supplemental benefit plans to individuals. It also has contract with Centers for Medicare and Medicaid Services to administer the Limited Income Newly Eligible Transition prescription drug plan program; and contracts with various states to provide Medicaid, dual eligible, and long-term support services benefits.
In addition, the company provides commercial fully-insured medical and specialty health insurance benefits comprising dental, vision, and other supplemental health and voluntary insurance benefits; financial protection products; and administrative services only products to individuals and employer groups, as well as military services, such as TRICARE South Region contract.
Further, it offers pharmacy solutions, provider services, predictive modeling and informatics services, and clinical care services, such as home health and other services to its health plan members, as well as to third parties. As of December 31, 2018, the company had approximately 17 million members in medical benefit plans, as well as approximately 6 million members in specialty products. Humana Inc. was founded in 1961 and is headquartered in Louisville, Kentucky.