Market Physician Executive

Description

As a Market Physician Executive, you will have these key responsibilities:

Clinical Leadership & Strategy:

• Collaborate as a clinical partner to Market operations leaders to manage and improve governance, management and performance of clinical medicine, patient care, and physician engagement (primary care and specialist).
• Provide clinical leadership and direction to the client physicians and provider network.
• Develop and implement clinical strategies to improve patient outcomes, reduce unnecessary care variation, reduce unnecessary utilization, and enhance care coordination. Ensuring delivery of optimal, medically necessary, compliant, high-quality, cost-effective care.
• Stay abreast of the latest clinical guidelines, best practices, and healthcare policy changes relevant to Medicare and Medicare Advantage patient populations.
• As part of the market executive team collaborate to develop and implement the market’s strategic plan.
• Actively lead physician leadership committees, including assisting with agenda creation, content development, and presenting/facilitating meetings as needed.

Quality Improvement & Performance Management:

• Oversee the development and implementation of quality improvement programs to enhance clinical performance, patient satisfaction, and safety.
• Recommend and implement process improvements designed to improve the efficiency, effectiveness, and success of physicians and clinicians.
• Monitor key performance indicators (KPIs) related to quality, cost, and utilization across all value-based contracts.
• Lead efforts to analyze performance data, identify areas for improvement, and implement effective interventions.
• Ensure compliance with all reporting requirements and quality standards set by CMS and other regulatory bodies.

HCC Coding and Documentation:

• Develop and implement strategies to ensure complete and accurate HCC coding.
• Educate providers on HCC coding guidelines and best practices.
• Oversee regular audits of medical records to assess coding accuracy and completeness.
• Collaborate with coding staff to address coding discrepancies and improve documentation.
• Monitor key performance indicators related to HCC coding and risk adjustment.

Provider Engagement & Collaboration:

• Facilitate communication and collaboration among providers to enhance care coordination and improve patient outcomes through the transparent sharing of information and data to inform improved clinical outcomes.
• Drive a positive culture that supports team-based collaboration and results that improve patient satisfaction, employee retention, and physician experience.
• Promote the development and growth of physicians and clinical staff.
• Demonstrate and lead providers toward accountability and oversight for goals, outcomes, and cost-effective clinical care.
• Foster strong relationships with participating providers and promote active engagement within value-based contracts.
• Provide education and training to providers on value-based care principles, population health management. Promote behavioral changes in providers when necessary.
• Support recruiting, hiring, onboarding, training, mentoring, and engagement of clinical providers.
• Align physicians and clinicians to the client’s expectations.
• Ensure physicians foster a culture that supports the client’s core values.

Patient Engagement & Care Coordination:

• Develop and implement strategies to improve patient engagement in their care and promote adherence to treatment plans.
• Provide ongoing support to physicians to promote clinical success managing chronically ill senior patients in a patient-centric and value-based care risk model through population health.
• Collaborate on care coordination programs to ensure smooth transitions of care and reduce hospital readmissions.
• Promote patient education and self-management support programs.

Risk-Based Contract Management:

• In collaboration with finance and contracting executive, support negotiations with health insurance companies for risk-based contracts, including capitation, bundled payments, and shared savings agreements.
• Analyze financial and clinical data to develop competitive contract proposals.
• Monitor contract performance and identify opportunities for improvement.

A Day in the Life:

• Actively engage in management, leadership, and committee meetings to promote performance in clinical outcomes, patient satisfaction, and company goals.
• Act as a change agent by promoting and supporting new enterprise-wide clinical workflows, processes, and initiatives by leading physicians through training, communication, and removal of barriers to change.
• Support physicians in their efforts to meet their clinical operational, patient satisfaction, panel growth, and financial goals, including P&L, Surplus, MLR, and EBITDA performance.
• Ensure physician and clinician compliance to EHR documentation regarding timeliness, accuracy, and coding, including HEDIS and MRA goals.
• Promote appropriate and compliant utilization management of medically necessary services in their Market(s).
• Advocate continuous clinical process improvement focused on patient outcomes and efficiency by championing opportunities to enhance development of EHR workflows, promotion of disease-specific protocols, and education of clinical staff.
• Promote the clinical adoption and engagement in the use of technology and compliance to support clinical workflows and operational efficiency.
• Promote utilization and coordination of clients preferred provider network, medically necessary specialty services, and other Part B patient care and cost-management strategies.
• Engage with hospitalists in their management of direct admissions, diversions, inpatient care, and transitions of care in pursuit of right care, right time and right setting.
• Participate in internal and external clinical audits and peer reviews as necessary.
• Oversee the development and implementation of performance improvement plans for physicians that result in expected improvements of performance and behavioral outcomes.
• Support each office/physician in ensuring access to care; work with physician on scheduling availability and capacity.

What Success Looks Like in this Role:

• Build trusting relationships with medical providers.
• Promote the goals of the client while ensuring the clinical and professional success of medical professionals.
• Advocate on behalf of both organizational leaders and providers by attentively assessing objectives and priorities; and by addressing matters promptly, courteously, and respectfully.
• Provide overall medical direction to support and develop clinical practice guidelines and protocols.
• Meet and exceed performance expectations within value-based care contracts.

Requirements

We are excited about you if you have these things:

• MD, licensed in the state of Oregon. 
• At least 5 years of work as a physician in a multi-physician and multi-facility organization.
• Board certification in a relevant medical specialty.
• Proven experience in negotiating and managing risk-based contracts with health insurance companies.
• Successfully practiced within full risk value-based care models and payment methodologies.
• Strong understanding of HCC coding guidelines and risk adjustment methodologies.
• Experience in medical record review and auditing.
• Effective oral, written, and telephone communication skills.
• Organizational skills; able to handle multiple priorities.
• Ability to work with diverse patient populations. 
• Proficient in electronic health records and other healthcare technologies.
• Strong analytical and problem-solving skills.

What you'll get:

Navvis is committed to attracting the most insightful and motivated talent by providing a candidate and onboarding experience that you won't find elsewhere! We foster an environment and culture that allow people to be creative, feel connected and be inspired to do their best work no matter where they are on the map. For all colleagues at Navvis, we strive to ensure that they have everything needed to be successful. From the basics like a competitive total rewards strategy, volunteering and social engagement activities to creating company experiences that challenge you to think differently and do different things as part of our never stop learning ecosystem, we support the whole person when you become a team member at Navvis.

Navvis offers a competitive benefits package including, but not limited to, medical, dental, vision, 401K with a safe harbor contribution and Paid Time Off plan starting at 2+ weeks.

Our Commitment:

Navvis is an equal employment opportunity and affirmative action employer seeking diversity in qualified applicants for employment. All applicants will receive consideration for employment without regard to race, ethnicity, color, gender, gender identity, age, religion, creed, national origin, ancestry, disability, perceived disability, medical condition, genetic information, military or veteran status, sexual orientation, or any other protected status, as defined by applicable law. Prior to the next step in the recruiting process, we welcome you to inform us confidentially if you may require any special accommodation to complete your application and participate fully in our recruitment experience. Contact us at H.R@navvishealthcare.com.
 

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