Physician Lead

About the role

The Physician Lead (PL) serves as a leader to a team of clinicians in a designated market responsible for handling a variety of health-related problems and educating patients and their families on wellness, prevention, and early detection. The PL is responsible for executing the clinical strategy through the management of their own patient panel as well as those of the clinicians whom they lead.

Responsibilities

• Working Collaboratively With Market CMO And Operational Leadership To Advance the Model of Care
• Create profit improvement initiatives
• Design operational implementations
• Contribute to the strategic intent
• Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA)
• Maintaining Collaborative / Supervisory Agreements per state protocols
• Assisting with panel management
• Providing direct education to clinicians around clinical protocols / disease prevalence / appropriate levels of clinical quality care
• Providing guidance to individual clinicians about patient terminations, in collaboration with Compliance
• Scheduling and managing PTO for staff
• Assisting with CME time and reimbursement requests
• Assisting with completion of performance reviews
• Assisting in resolution of inquiries, requests, and complaints from clinical staff
• Assisting in organizing team building activities
• Assisting in resolution of inquiries, requests, and complaints from patients
• Ongoing chart review / audit of clinical staff to ensure quality care and identifying opportunities for education/coaching
• Optimizing network; preferred network specialists – contributing to the identification of preferred network specialists to optimized delivery of care for ongoing maintenance / cost saving opportunities
• Making decisions related to the identification and mitigation of complex technical and operational problems within clinics/centers
• Managing financial / operational performance of their assigned clinics to ensure success
• Participating in provider committees (i.e. Technology Governance, EMR Optimization, etc.) and attending meetings regularly
• Participating in shared service strategy meetings
• Participating in quality improvement programs, population health programs, continuing education, and other patient care programs established by clinical requirements
• Assisting in recruiting and interviewing of potential clinical staff
• Participating in patient retention and marketing activities as required

Requirements

• MD/DO with 8 or more years of clinical experience
• 2 or more years of project leadership experience
• Licensure requirements of the state of jurisdiction
• Board Certification in Family Medicine, Internal Medicine or Geriatric Medicine

Qualifications

• Active and unrestricted DEA license
• Medicare Provider Number
• Medicaid Provider Number
• Minimum of three 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
• Good understanding of best practice coding and documentation in value based environment
• Leveraging Technology: Technological savvy and knowledge sharing
• Problem Solving: Encourages collaborative problem solving
• Accountable: Meets expectations and takes responsibility for achieving results
• Clinical Knowledge: Understands clinical program design, implementation, management/monitoring to support choice in consumer medical care
• Communication: Active listening and continuous understanding

Skills

• Strong leadership and project management skills
• Excellent interpersonal and communication skills
• Ability to work collaboratively with cross-functional teams
• Proficient in clinical protocols and disease management
• Experience with healthcare technology and systems
• Strong problem-solving abilities

Benefits

Humana offers competitive benefits that support whole-person well-being. Associate benefits include medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance, and many other opportunities.

Pay

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $292,000 - $341,500 per year

Schedule

This role is considered patient facing and is part of Humana/Senior Bridge's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.