Territory Medical Director, Physician
Location: On-Site, FL-SFL-Flagler, Brandon, FL, Pembroke Pines, FL, Coral Springs, FL, Miami, FL
Time Type: Full time
Posted: 4 Days Ago
Job Requisition ID: JR1530
It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.
Job Summary
The Territory Medical Director reports to the Vice President of Practice Operations and directly oversees medical and clinical activities for Cano Health within their assigned territory. Exercises professional judgment to oversee the performance/practice of medicine by our employed or contracted physicians and uses best efforts to ensure that such services are provided in a safe, competent, and efficient manner for our members.
Essential Duties & Responsibilities
- Ensure compliance with adverse incident reporting requirements.
- Conduct systematic reviews of clinic billings to ensure that the billings are not fraudulent or unlawful.
- Conduct periodic chart reviews on providers in accordance with state regulations.
- Render decisions related to patient safety or medical quality in situations where written policies do not exist or are not clear.
- Optimize utilization of Cano’s services and resources and ensure adequate staffing levels for the clinical areas within the Group.
- Facilitate member medical decisions and provide direction to providers regarding member emergent and emergency care.
- Develop, maintain, organize, and implement the QIP, proper documentation, verification, and HEDIS audits according to Cano’s protocols.
- Work with other assigned District administrative staff to review clinical team’s performance and improve quality of care.
- Participate in Medical Directors meetings to discuss clinical team performance and implement Cano Health protocols.
- Review all adverse events and determine whether such events are reportable in accordance with applicable law.
- Evaluate all medical grievances from providers and coordinate solutions with the team.
- Conduct monthly meetings with District Medical Directors and Directors of Operations to review clinic issues and policies.
- Sign or co-sign pertinent documents in the absence of a Provider.
- Review PCPs Scorecards/Utilization to include Utilization, HEDIS, ER/Admission, patient volume, KPI’s defined by Senior Leadership.
- Meet with physicians within their district to complete performance reviews and bonus discussions.
- Provide physician leadership and mentorship on clinical best practices.
- Oversee the review and approval of CME time off, expense approvals, and PTO approvals over ten days.
- Work with District Medical Directors and Directors of Operations in handling provider performance matters.
- Assist with project-based requests and provide clinical advice to respective company departments.
- Work with the Quality Director to establish HEDIS strategies.
- Establish Provider Recognition Initiatives and develop strategies for caring for high-risk members.
Education & Experience
- Medical degree with National Board Certification in family medicine, internal medicine, or emergency medicine.
- Current National Board Certification or eligible.
- 5+ years medical leadership/directorship experience.
- MBA preferred.
- 5+ years Value Based Care experience.
Knowledge, Skills & Proficiencies
- Skilled in operating phones, personal computers, software, and other IT systems.
- Skilled in oral communication.
- Ability to communicate professionally with associates, patients, and other individuals.
- Detail-oriented with accuracy in reports and data.
- Fluent in English and Spanish preferred.
Physical Requirements
This position works under usual office conditions, requiring the ability to work at a personal computer and be on the phone for extended periods. Must be able to stand, sit, walk, and occasionally climb. The incumbent must be able to lift up to 50 lbs.
Work Conditions
Must be able to perform essential functions such as typing, standing, sitting, and occasionally climbing.
Travel Requirements
Expected travel: 0-25%. Work will involve some driving/traveling to assigned clinics.
Disclaimer
The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
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