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MEDICAL DIRECTOR – Provider Performance

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Chicago, IL
Job Type
Direct Hire
Medical Doctor, Doctor of Osteopathy
Apr 18, 2019
Job ID
MEDICAL DIRECTOR – Provider Performance - MCO
This UNIQUE opportunity will focus on provider engagement and achieving performance results in value based care.  Medical Director will provide support and bring insight, innovation and opportunities to the physicians contracted with the health plan.  MD enhances understanding of value-based contracts across all lines of business and provides education and guidance around cost of care and use analytic tools and reporting.
MD will develop alliances with the provider community through the development and implementation of the medical management programs.
May represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues.
Represents the business unit at appropriate state committees and other ad hoc committees

Responsible for the provider performance program by guiding physician groups, local markets and medical staff on the value of the program for members improved quality of care, lower cost of services and improved financial reimbursement for providers who are successful in managing quality, access and overall costs.

Monitors competitor products and internal provider performance reporting capabilities and responds with recommended enhancements

Accountable for achieving performance results in value based care by engaging with providers in joint operating committees and buildsing relationships with clinical leadership of provider collaboration groups.
Designs and develops market interventions leveraging existing tools that will drive performance in value-based care. Provides expertise, captures and shares best practices across regions to provider partners as well as other medical directors.
Collaborates with provider engagement team to bring insight, innovation and opportunities that help drive performance.

-MD or DO, must be board certified preferable in a primary care specialty (Internal Medicine, Family Practice, Pediatrics or Emergency Medicine).
-Actively practicing physician.
-Willing to travel across IL for provider meetings and engagements.
-Previous experience within a managed care organization is preferred.
-MUST have experience with value base care and provider performance
-Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is preferred. Experience treating or managing care for a culturally diverse population preferred. 
-As an outward facing position, this role requires exceptional interpersonal skills, good communication skills and collaboration

- Current IL medical license without restrictions.