-
Medical Director
1 week ago
Removery Birmingham, United StatesAbout Removery: · Join us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in people's lives by supporting them as they embrace change throug ...
-
Medical Director
2 weeks ago
REMOVERY LLC Birmingham, United StatesAbout Removery: · Join us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in people's lives by supporting them as they embrace change throu ...
-
Medical Director
1 week ago
Protective Life Insurance Company Birmingham, United StatesProtective Life Corporation is seeking an experienced Medical Director to support our Underwriting Department. This is a remote position. The new hire will work with other Medical Directors at Protective and will report to the Chief Underwriting officer. · Principal Responsibili ...
-
Medical Director
3 weeks ago
Removery, LLC Birmingham, United StatesJoin us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in people's lives by supporting them as they embrace change through their tattoo rem ...
-
Medical Director
4 days ago
REMOVERY LLC Birmingham, United StatesAbout Removery: · Join us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in people's lives by supporting them as they embrace change throu ...
-
Medical Director
2 weeks ago
REMOVERY LLC Birmingham, United StatesJob Description · Job DescriptionAbout Removery: · Join us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in people's lives by supporting t ...
-
Medical Director
3 weeks ago
REMOVERY LLC Birmingham, United StatesAbout Removery: · Join us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in peoples lives by supporting them as they embrace change throug ...
-
Medical Director
3 weeks ago
Removery Birmingham, United StatesAbout Removery: · Join us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in people's lives by supporting them as they embrace change throug ...
-
Medical Director
6 days ago
REMOVERY LLC Birmingham, United StatesAbout Removery:Join us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in people's lives by supporting them as they embrace change through t ...
-
Medical Director
3 weeks ago
AIDS Healthcare Foundation Birmingham, United StatesAIDS Healthcare Foundation is public health, mission-based organization with a network of services that include healthcare centers, pharmacies and wellness clinics. We are now looking for a family practice or internal medicine physician at an AHF HIV primary care outpatient facil ...
-
Veterinary Medical Director
3 weeks ago
BluePearl Pet Hospital Birmingham, United StatesBluePearl Pet Hospital located in Birmingham, AL is seeking a collaborative, engaged, and passionate veterinary leader with several years of clinical experience to lead our team of emergency and specialty clinicians in the role of Medical Director. The Medical Director will partn ...
-
Practice Medical Director
1 week ago
Monogram Health Birmingham, United StatesPosition: Practice Medical Director - Birmingham, AL · Lead the strategic transformation toward value-based care models as our Practice Medical Director. Drive innovative initiatives within accountable care organizations (ACOs) and bundled payment programs, guiding our team towar ...
-
Practice Medical Director
1 week ago
Monogram Health Birmingham, United StatesPosition: Practice Medical Director - Birmingham, AL · Lead the strategic transformation toward value-based care models as our Practice Medical Director. Drive innovative initiatives within accountable care organizations (ACOs) and bundled payment programs, guiding our team towa ...
-
Director 8 Medical/Surgical
1 week ago
Community Health System Birmingham, United StatesJob Description · The Director of Med/Surg is accountable and responsible for the effective delivery of competent, compassionate, and efficient patient care Medical Unit and Surgical Unit. This includes overall direction of clinical, human resources, and financial management. Gra ...
-
Medical Director in Birmingham, AL
3 weeks ago
TeamHealth Birmingham, United StatesJob DescriptionStep up your leadership career in Birmingham, AL We need you to lead our team at St. Vincent East Medical Center. St. Vincent East Medical Center in central Birmingham is looking for an experienced director or associate director to oversee a 16-clinician program. T ...
-
Medical Director in Birmingham, AL
3 weeks ago
TeamHealth Birmingham, United States Full timeStep up your leadership career in Birmingham, AL We need you to lead our team at St. Vincent East Medical Center. St. Vincent East Medical Center in central Birmingham is looking for an experienced director or associate director to oversee a 16-clinician program. · This facility ...
-
Senior Market Medical Director, East Region
2 weeks ago
ArchWell Health Birmingham, United StatesSenior Market Medical Director, East Region · Birmingham, AL, USA * Charlotte, NC, USA * Kansas City, KS, USA * Kansas City, MO, USA * Oklahoma City, OK, USA * St. Louis, MO, USA * Tulsa, OK, USA * Virtual · Req #11406 · Tuesday, April 2, 2024 · Senior Market Medical Director ...
-
Medical Director
3 weeks ago
REMOVERY LLC Birmingham, AL, United StatesAbout Removery: · Join us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in people's lives by supporting them as they embrace change throug ...
-
Medical Director
2 weeks ago
REMOVERY LLC Birmingham, AL, United States Full timeAbout Removery: Join us in our journey of normalizing tattoo removal around the world Removery is an innovative, collaborative laser tattoo removal company. We take pride in our mission to make a real difference in people's lives by supporting them as they embrace change through ...
-
CSL Plasma Birmingham, United States1. Serves as the primary physician for reporting to the Food and Drug Administration and in such capacity provides medical oversight in compliance with applicable Federal and State regulations including the applicable sections of Title 21 of the Code of Federal Regulations and mo ...
AVP Stars and Risk Adjustment National Medical Director - Birmingham, United States - Humana
Description
AVP Stars and Risk Adjustment National Medical DirectorLocation
Birmingham, AL, United States
Employment Type
Full-Time
Posted on
Apr 28, 2023
Apply for this job
your email:
upload resume:
Profile
Job Information
Humana
AVP, Stars and Risk Adjustment National Medical Director
in
Birmingham
Alabama
Description
The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that can contribute to Humana's national planning and operations for Risk Adjustment, Stars, and Interoperability.
As an individual contributor, this role will: 1) inform and support HQRI's provider strategy across Stars, RA, and Interoperability, 2) serve as a coding expert to manage escalations or establish compliant policies, and 3) contribute as a clinical industry representative.
As a leader, this role leads HQRI's Provider Support team (PST) that drives national provider education strategy and operations along with provider communication operations.
HQRI is an organization with over 900 associates that leads Humana'sStars, Risk Adjustment and Interoperability strategy, operations, and performance nationally.
This role relies on medical background, business acumen, and industry-standard clinical / coding guidance to ensure physician and healthcare provider plans, education, reporting and materials are accurate and consistent across the enterprise to support regional and corporate strategic initiatives.
The Associate Vice President (AVP), Stars and Risk Adjustment National Medical Director leads key strategic and operational functions.
In collaboration with corporate stakeholders and regional teams, this role is responsible for supporting corporate and regional strategies for physician and healthcare provider education or operations for Risk Adjustment and Stars.
In addition, the position provides supportive clinical and coding expertise across the teams in HQRI. Lastly, this leader will be instrumental in supporting interoperability efforts.This position reports the Vice President of Strategy Advancement in the Healthcare Quality Reporting and Improvement organization (HQRI) and collaborates significantly with the HQRI Senior Leadership Team across its programs.
This is a remote position with travel expectations up to 25%.Major responsibilities include
Inform HQRI's provider strategy and increase adoption of Humana's Stars, MRA, and interoperability strategy and programs
Lead a team/organization of 10 associates across three functions: Education of Humana's Market-based associates on how to drive accurate reporting through provider education; Provider communications; policies and procedures aligned to those functions
Serve as HQRIs clinical industry representative (e.g., Conferences; national vendor or provider partners)
Serve as a coding expert, which may include working through escalations on coding disputes, policy development or refinement, and coordination and education with providers or Humana associates
Required Qualifications
MD or DO degree
A current and unrestricted license in at least one jurisdiction
Board Certified in an approved ABMS Medical Specialty
Excellent communication skills, both written and verbal
5 years of established clinical experience
Knowledge of the managed care industry including Medicare, Medicaid and / or Commercial products
Must be passionate about healthcare quality and contributing to an organization focused on maintaining accuracy of coding and documentation to capture the true health status of our members thru risk adjustment initiatives
Experience with quality assurance and/or regulatory compliance
Travel up to 25%
Preferred Qualifications:
Certification in diagnosis coding (must receive AAPC certification within one year of hire)
Ability to help develop and use data and analytics to drive sustainable results
External communications for physicians and healthcare providers
Prior experience leading teams focusing on the accuracy of medical record documentation and diagnosis coding
Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.
Working knowledge of risk adjustment concepts
Internal Medicine, Family Practice, Geriatrics, OBGYN, Hospitalist clinical specialty
Detail oriented and effective listener
Experience with Stars, including HEDIS, CAHPS and HOS
Prior experience in a business function or business consulting role
Additional Information:
Vaccine Policy
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters.
Scheduled Weekly Hours
40
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion.
Humana Inc.
Website :
DescriptionHumana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being.
As a company focused on the health and well-being of the people we...DescriptionHumana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being.
As a company focused on the health and well-being of the people we...DescriptionProvides executive leadership to Humana.
ResponsibilitiesVice President, Threat Management & ResponseJob Description:
Humana is a Fortune 50 market leader in integrated healthcare whose dream is to help people a...
#J-18808-Ljbffr