Medical Director of Clinical Performance

Overview

Required skills & experience: 1. Medical Doctor Degree (MD) or Doctor of Osteopathic Medicine (DO) required. 2. Advanced degree, such as MBA, MHA, MPH, MMM, or a related field preferred. 3. Board Certified in in a specialty approved by the American Board of Medical Specialists or the American Board of Osteopathy. 4. Ten (10) years of progressively more responsible experience in a healthcare environment. 5. Five (5) years management or supervisory experience in healthcare strongly preferred. 6. Health care practice experience providing services to Medicare Advantage and Medicaid patients required. 7. Broad experience of the Medicare segment and an understanding of the overall Medicare stars program. 8. Must have experience on the health plan/payor side, not looking for provider side experience. What you need to know: 1. Senior level role responsible for providing medical leadership over the Senior Health Services team’s Medicare Stars program. 2. Responsible for continuous improvement of clinical HEDIS, Pharmacy, HOS, and CAHPS scores. 3. Work directly with medical leadership at contracted provider organizations to assist them in reaching their clinical goals. 4. Oversee the development and implementation of the strategic plan to achieve and retain 4.5 STARs for the HMO and PPO. 5. Opportunity to join an innovative, trailblazing company with industry leading culture and benefits. 6. Monthly vehicle stipend, however work is currently remote during this pandemic. 7. Will not have any direct reports with this role.

Benefits

Company

We are driven by a singular goal — improving the health and safety of our customers and our communities. How do we do that? We create innovative insurance products, technology solutions and services to support our key stakeholders — individuals, employers, providers and strategic partners — improving the health and safety of the people and places we serve.