Care Team Medical Director

Profile

Job Information

Humana

Care Team Medical Director

in

San Juan

Puerto Rico

Description

The Care Team Medical Director is responsible for improving the quality of care and outcomes while managing costs for a defined group of people most impacted by health disparities and health inequity. This role presents the unique opportunity to be a part of building an innovative clinical strategy and shaping the necessary tech-enabled services to deliver on that experience from the ground up. The Care Team Medical Director will be an integral part of the Care Team Leadership Team. This role requires experience leading direct and in-direct teams and an understanding of how we can provide care more efficiently and effectively with an interdisciplinary team.

Responsibilities

Author by Humana: Who We Are

Imagine using your workday to make a meaningful difference in people's lives. Envision working in an environment where you are not only encouraged to create a positive change but also given the tools and support to make that change happen. 

Welcome to Author by Humana! We are the future of healthcare and our mission is to transform the experience that we provide for seniors - working to meet their social, emotional, and medical needs. As an Author by Humana associate you will help members through their healthcare journey, ensuring they get the guidance and support they need so they can focus on fulfilling their life's ambitions and goals. At Author by Humana, whole person health is about discovery, connections and community.  

This is a unique opportunity to help shape the technology-enabled services we will build together to deliver on our shared vision. We are looking for individuals who are: 

Passionate about transforming our healthcare system for those who need it most  

Compassionate towards seniors who need help navigating their healthcare

Excited to lead a team of associates as they transform member experiences

Driven to do well by doing what's right for our members and associates

Willing to thoughtfully disrupt the status-quo and excited to work in a rapidly evolving start-up environment 

The Care Team Medical Director is responsible for improving the quality of care and outcomes while managing costs for a defined group of people most impacted by health disparities and health inequity. This role presents the unique opportunity to be a part of building an innovative clinical strategy and shaping the necessary tech-enabled services to deliver on that experience from the ground up. The Care Team Medical Director will be an integral part of the Care Team Leadership Team. This role requires experience leading direct and in-direct teams and an understanding of how we can provide care more efficiently and effectively with a interdisciplinary team.

Responsibilities

Author by Humana is looking for a Physician for our Care Team Medical Director role. In this role you will:

Provide clinical mentorship for the chronic disease management and clinical pathway work with an interdisciplinary care team.

Serve as the medical leader for clinical collaboration with local provider and market teams.

Serve as the medical leader for the Care Team Clinical Quality Program including monitoring, evaluation, and quality improvement activities,

Serves as the medical leader for the member outreach for stars/HEDIS programs.

Required Qualifications

MD or DO degree

5 years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age).

5 years of building teams and supervising interdisciplinary clinical teams.

2 years experience in an Administrative role in a healthcare setting

Current and ongoing Board Certification an approved ABMS Medical Specialty

A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required.

No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.

Excellent verbal and written communication skills .

Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation.

Innovation, start-up experience

Preferred Qualifications

Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.

Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists

Advanced degree such as an MBA, MHA, MPH

Exposure to Public Health, Population Health, analytics, and use of business metrics.

Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.

The curiosity to learn, the flexibility to adapt and the courage to innovate

Additional Information

This position is hybrid of working at home and working in the office. Estimated travel approximately 1x per month- may be higher per month if not located in SC, KY or MA

Scheduled Weekly Hours

40

Company info

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