Medical Director – Population Health, Provider Education

Job not on LinkedIn

🔥 27 minutes ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $214.1k - $297.9k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Horizon Connect @ Wall BCBSNJ

WebsiteLinkedInAll Job Openings

2 - 10 employees

⚕️ Healthcare Insurance

🏥 Healthcare

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ is a LinkedIn presence or local program/office associated with Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). Based on the name and context, it appears to be connected to Horizon BCBSNJ’s health insurance operations and local outreach or member/provider engagement in the Wall, NJ area. Publicly available information provided is limited and mostly LinkedIn site chrome rather than a company profile, so this description is conservative and based on the affiliation indicated by the name.

📋 Description

• Design curriculum for provider education including but not limited to value based clinical workflows, utilization reduction strategies, quality, member experience, health equity and disparities, and appropriate risk adjustment/ coding. • Develop provider education materials and approaches for providers at varying levels of readiness to transform. • Collaborate with internal and external SMEs (e.g. other medical Directors, quality and risk adjustment teams, and others) to receive relevant materials, insights, and strategies to be incorporated. • Partner with SIG and their many work-streams to ensure learnings and strategy are incorporated. • Research and incorporate global, national, and state based leading evidence based practices. • Use output of Voice of Provider surveys and Population health surveys to inform this work. • Create provider transformation evaluation process for benchmark and interval evaluation. • Identify and refine key KPIs, in collaboration with enterprise partners, to incorporate into partner facing initiatives that will drive change in our VBP and FFS partner portfolio. • Research forward-thinking transformation practice models and programs for incorporation into partner playbooks to improve performance. • Partner with network facilities and providers to develop and implement initiatives that drive quality, manage cost and improve performance. • Establish multidisciplinary teams for partner transformation engagement, for example, with transformation coach interactions, clinical collaboration calls, special KPI projects, etc. • Serve as physician SME for projects related to transformation and Health Care Value across the enterprise, such as Clinical Performance Measurement & Predictive Analytics, Strategic Initiatives Group, Medical Economics and Risk Adjustment, etc. • Design, update, implement, and review biannual value-based partner population health surveys. • Train value-based team on the interpretation of clinical insights reports and the message delivery to partners. • Research, design, update, and implement value based quality program for each program year.

🎯 Requirements

• Requires an Medical Doctor (MD) or Doctor of Osteopathy (DO) degree. • Requires a minimum of 10 years clinical experience in patient centric/value based setting, NCQA certification preferred. • Requires a minimum of 5 years of medical management experience in a managed care setting. • Requires physician leadership experience in integrated delivery systems with financial accountability. • Requires experience with management of physicians and non-physicians.

🏖️ Benefits

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement