MemorialCare Medical Group is a physician-based organization established to provide advanced comprehensive, effective and efficient health care. With over 30 locations from Long Beach to Dana Point, MemorialCare Medical Group includes more than 250 physicians in the areas of internal medicine, family medicine, pediatrics, geriatric medicine, cardiology, cardio thoracic surgery, gastroenterology, neurology, pulmonology, psychiatry, psychology, rheumatology, sleep medicine and therapeutic acupuncture.
Provides medical leadership for the MemorialCare Medical Foundation (MCMF) and MemorialCare Medical Group (MCMG) via work with physicians, physician leaders and staff. Directs, monitors, evaluates and coordinates activities of the MCMG physicians, advanced care practitioners and medical group division employees engaged in the delivery of medical care and medical management services to assure quality patient care and experience. Develops and monitors medical policy and operations. Assists the Chief Medical Officer (CMO) in developing tactics to improve MCMF and MCMG performance. Monitors providers to ensure appropriate staffing along with compliance with all legal and regulatory requirements.
Principal Duties and Responsibilities:
* Assists the CMO in developing and implementing an annual strategic plan and budget.
* Implements and directs the transformation of the outpatient delivery system to a patient-centered and fully integrated delivery system in collaboration with physicians and staff.
* Assists the CMO with strategic planning for physician growth, primary care, specialists, and office locations.
* Directs provider recruiting efforts to support MCMG, MCMF and MHS strategic goals.
* Supports the implementation of the medical aspects of population health initiatives for MCMG.
* Promotes the development of best practices, evidence-based medicine and the meaningful use of technology.
* Assists the CMO and other Medical Directors in the implementation of MCMF informatics, patient experience, quality improvement and performance improvement (P4P) initiatives.
* Assists the CMO with the integration of physicians into the medical group.
* Assists the CMO, in collaboration with other Medical Directors, with Utilization Management/Case Management/Disease Management programs with a focus on synergy and minimizing network leakage.
* Oversight of Primary Care Physician (PCP) and Specialist credentialing program.
* Collaborates with the Quality Improvement, Peer Review, Integration, Risk, Performance Improvement, Practice Transformation committees. Directs grievance review, physician counseling and education.
* MCMF/MCMG Meetings include but are not limited to: MCMG Board of Directors, MCMG Leadership Council, Executive Management Team, MCMG Executive Committee, MCMF JOC and Regional Medical Director Forum,
* Supports and oversees coordination and administration of the Golden Stethoscope (Hagadorn) Award program.
* Develops and implements Continuing Medical Education (CME) and other educational activities including Grand Rounds.
* Supports the advancement of the anti-coagulation clinic, diabetes clinic, post-discharge clinic (Comprehensive Health Care clinic or CHC), and other special clinics, as developed. Assists the CMO in development of new clinics to better manage chronic disease and prevention.
* Monitors programs to improve patient, family and provider satisfaction.
* Direct management and oversight of the Regional Medical Directors.
* Management of facility medical directors and ensures they perform their functions as described in the provider rules and regulations.
* Promotes effective communication among providers, Associate Medical Directors, Facility Medical Directors, Regional Medical Directors and staff.
* Collaborates with the VP of Operations to ensure offices operate as efficiently as possible with continuous efforts at improving quality metrics, patient experience, population health and value.
* Works with the Regional Medical Directors, Facility Medical Directors and Associate Medical Directors to develop and implement new medical management initiatives and programs.
* Collaborates with Medical Management, the Regional Medical Directors, Facility Medical Directors and Associate Medical Directors to manage specialty claims cost.
* Works closely with Network Management and Provider Relations to ensure effective education and maintenance of outside specialty network.
* Monitors and directs company compliance with government and contractual requirements. Monitors provider charge analysis, charge audits, documentation and adherence to Medicare guidelines.
* Monitors provider profile data reports and provides consultation and interventions directly or through the Regional and/or Facility Medical Director as needed, including disciplinary action per policy/procedure.
* Works with Medical Directors and Associate Medical Directors to facilitate quality assurance and other provider activities.
* Assists the CMO in development of the compensation policy for Physicians and Advanced Care Practitioners.