Executive Medical Director, Value-Based Care

Darum lohnt es sich

• Serve as primary clinical leader for relationships with advanced primary care, value-based specialty care, and complex care providers • Lead assigned senior clinical specialists • Partner with Network value-based contracting, analytics, and actuarial teams to evaluate total cost of care, quality, and experience performance • Shape engagement strategy with advanced primary care, value-based specialty care, and complex care providers • Determine where to expand or contract provider relationships • Take accountability for provider-group performance on cost, quality, and experience, including MA Stars measures • Collaborate as part of the Medical Affairs Network leadership team to improve provider performance across all lines of business • Ensure timely execution of deliverables according to due dates and Federal/state regulatory requirements • Partner with providers clinically to support their success on behalf of members Requirements • MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) • Active and current medical license (MD or DO) without encumbrances • Board Certification including Maintenance of Certification in an American Board of Medical Specialties specialty • 5-10 years of work experience in managed care, value-based care, and quality • 5 years of work experience in value-based care delivery • Ability to work effectively in a highly matrixed organization/environment • Ability to engage physicians, vendors, community partners, administrative leaders, clinical leaders, and staff • Ability to manage multiple priorities and adapt to change • Ability to work virtually with occasional travel for in-person meetings • MBA or MPH preferred • Medical informatics and/or data science experience preferred Core Competencies Demonstrates expertise in clinical leadership, value-based care delivery, and managed care, with a strong focus on provider performance and regulatory compliance.

Capable of engaging diverse stakeholders and managing complex relationships to enhance quality and cost-effectiveness in healthcare.

Highest-signal resume keywords • MD Or DO • Board Certification • Value-Based Care Delivery • Managed Care Experience • Medical Informatics ATS Optimization Keywords Hard Skills • Clinical Leadership • Cost Evaluation • Quality Performance Analysis • Engagement Strategy Development • Provider Relationship Management Soft Skills • Effective Communication • Adaptability • Collaboration • Priority Management Certifications & Qualifications • Active Medical License • Board Certification Industry Keywords • Value-Based Specialty Care • Complex Care Providers • MA Stars Measures • Federal Regulatory Requirements • Matrixed Organization Tools & Technologies • Data Science • Medical Informatics