Medical Director - Training and Implementation

Profile

Description

Healthcare isn't just about health anymore. It is about caring for family, friends, finances, and personal life goals. It's about living life fully. At the Primary Care Organization, a division of Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. We're seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry.

Responsibilities

In this role, you will work closely with the clinical education and market implementation teams under the Humana Primary Care Organization (PCO). Collaboratively with market leadership, you will train primary care providers in quality-based, senior-focused medicine for existing and new centers in the PCO. As a provider trainer, you will be the ambassador for value-based, senior care model in the primary care network.

The main responsibilities of the role are:

Develop, plan, organize, and supervise training for primary care providers including principles of population health, value-based care, senior care. May also need to incorporate EMR, compliance, primary care policy and procedure, coding and documentation, quality, utilization, customer service standards, team communication as needed. Training could occur in-person in markets and virtually through live and recorded sessions.

Serve as the Subject Matter Expert (SME) on clinical value-based care practices and participate in building and maintaining training content for the PCO University.

Monitor medical performance and provide guidance to ensure that the quality of care being provided meets appropriate standards and to ensure cost-effective utilization practices.

Work collaboratively with implementation teams, compliance, market teams and PCO leadership to identify training needs for providers.

Represent the organization in recruiting and marketing events.

Support, mentor and partner with advanced practice providers on the training team.

Maintain active clinical practice in the local market for a portion of the time.

Required Qualifications

Board Certified MD/DO in Family Medicine, Internal Medicine or Geriatric Medicine

Maintain license in state of practice and if needed, sites of training

Minimum 5 years' experience in clinical practice

Medical staff leadership experience for a large provider group practice, physician practice management organization, hospital/hospital system, or an MCO preferred

Experience supporting and facilitating training initiatives for physicians and advance practice providers (APP), experience working with APPs preferred

Interest in developing and supporting the development of evidence-based clinical pathways in Geriatrics and value-based care, prior experience in this area preferred

Experience with performance improvement and change management

Knowledge of Medicaid and Medicare programs, specifically Medicare Advantage; Strong knowledge of MA coding and documentation policies and procedures in a value-based relationship

Basic computer skills: Microsoft Office applications, Word and Excel, email, apps, and navigating the EMR. eCW experience is preferred.

Ability to travel up to 50%, largely within local and regional markets.

Key Competencies

Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results

Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving

Accountable: You meet clearly stated expectations and take responsibility for achieving results

Clinical Knowledge: You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs

Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience

Reporting Relationships

This area is under the leadership of Humana's Primary Care Organization Chief Medical Officer.

Vaccine Policy

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

#LI-CH1

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com