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Clinical Program Director
3 weeks ago
Healogics Doral, United StatesThe rewards at Healogics are immense, starting with the important work we do to change patients' lives. We also understand that meaningful work is hard work, and we are committed to supporting and compensating our employees for the tremendous service they provide. · Think you are ...
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VASL Doral, United StatesPosition Details: · Schedule: · Full time Monday to Friday · Work Location: · In-person in Miami (9350 Sunset Drive, Suite 101) · Job Overview: · Assistant Clinical Director for Adolescent Program · Are you driven by a deep commitment to improving the mental health and well ...
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Clinical Program Manager
1 week ago
InsideHigherEd Coral Gables, United States Administrative Jobs ,Current Employees:If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review th ...
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Clinical Program Manager
1 week ago
University of Miami Miami, United States Full timeCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here $) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please re ...
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Clinical Program Coordinator
1 week ago
University of Miami Miami, United StatesCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here $) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please re ...
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Clinical Program Coordinator
1 week ago
UOMUOMUS Miami, United States OTHERCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review ...
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Simulation Lab Instructor
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West Coast University Doral, United States Full timeCome care with us at West Coast University As a Nursing Faculty member for a certified Great Place to Work, you will guide nursing students to do more than change their own lives - you will help change the lives of every patient they treat throughout their career in healthcare. A ...
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Information Technology Specialist
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US Military Treatment Facilities under DHA Doral, United States**Duties**: · - Serves as a member of the US Army Health Clinic Information Management Office Technical Support Team to support the Help Desk and Hardware/Software Customer Service · - Manage customer requests for Information Technology (IT) services or problems in the most effic ...
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Clinical Program Coordinator
1 week ago
UOMUOMUS Miami, United States OTHERCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review ...
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Clinical Program Manager
1 week ago
UOMUOMUS Miami, United States OTHERCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review ...
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Sr. Clinical Program Coordinator
1 week ago
University of Miami Coral Gables, United States Full timeCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review th ...
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Sr. Clinical Program Coordinator
1 week ago
University of Miami Miami, United StatesCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review ...
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Sr. Clinical Program Coordinator
1 week ago
University of Miami Miami, United StatesCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review ...
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Home Health Aide 2- Ppv
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Humana Doral, United States**Become a part of our caring community and help us put health first***: Our HHA/CNA will be responsible for keeping the patient's environment clean and safe. It will Provide companionship to the patient and assist with care of children and will Provide escort services such as ta ...
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Sr. Clinical Program Coordinator
1 week ago
University of Miami Miami, United StatesCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here $) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please re ...
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Sr. Clinical Program Coordinator
1 week ago
University of Miami Miami, United StatesCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here $) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please re ...
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Sr. Clinical Program Coordinator
1 week ago
University of Miami Miami, United StatesCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review ...
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Sr. Clinical Program Coordinator
1 week ago
UOMUOMUS Miami, United States OTHERCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review ...
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Sr. Clinical Program Coordinator
1 week ago
UOMUOMUS Miami, United States OTHERCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review ...
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Sr. Clinical Program Coordinator
5 days ago
UOMUOMUS Miami, United States OTHERCurrent Employees: · If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review ...
Medicare Medical Director Clinical Programs - Doral, United States - Elevance Health
Description
Wellpoint, formerly Amerigroup, is a proud member of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states.
This is an individual contributor role. This position will work a hybrid model (remote and office).
The ideal candidate will live within 50 miles of one of our Elevance Health office locations Work schedule:
Monday - Friday, standard business hours.
The Medical Director Clinical Programs is responsible for designing and implementing clinical programs with specific medical condition focus for all lines of business enterprise wide.
Analyzes and interprets data in collaboration with data and analytics to identify opportunities. Partners with LOB (line of business) and Market leaders to ensure clinical solutions align with membership health priorities. Collaborates with payment innovation on clinical programs that support providers in value-based payment arrangements. Serves as a subject matter expert/collaborator with LOB, leaders, and other clinical initiatives including cost of care.This role will work on Cost of Care, trend management, value-based care support for STARS/HEDIS and correct coding initiatives with providers as well as strategic growth and innovation initiatives.
How you will make an impact:
Designs and develops national level interventions leveraging existing tools that will drive performance in value-based care in support of the innovation and execution of corporate clinical interventions.
Provides clinical expertise, captures and shares best practices across regions to provider partners as well as the company's medical directors by way of studying designs, analytics and reporting for clinical quality that drives improved healthcare outcomes.
Provides an end-to-end clinical solution by taking a problem from initiation to execution with reporting and analytics as an outcome.
Accountable for achieving performance results in value-based care by engaging, influencing and supporting physicians.Engages with providers in joint operating committees and builds relationships with clinical leadership of provider collaboration groups.
Promotes clinical best practice sharing across all lines of business to improve results and drive efficiency and effectiveness.
Works to develop and deliver high impact interventions, supporting content development and practice transformation embedded capabilities to significantly improve provider performance that drive cost of care and improve HEDIS/Stars where applicable.
Minimum Requirements:
Requires MD or DO and Board certification approved by one of the following certifying boards is required, where applicable to duties being performed, American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
Unless expressly allowed by state or federal law, or regulation, must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US military base, vessel or any embassy located in or outside of the US.
Minimum of 10 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
Consulting experience and/or MBA.
Managed care experience improving cost of care trend.
Experience working with provider groups including practice managers, population health and quality directors on improving STARS/HEDIS or Risk Adjustment performance.
Six Sigma or formal process improvement experience preferred.Analytical experience in creating study designs, ROIs and statistical techniques preferred.
Advanced knowledge in health care systems and health policy, quality measures, performance measurement, and quality improvement, and the clinical understanding for clinical quality programs strongly preferred.
Travel up to 25% may be required depending on market needs.#J-18808-Ljbffr
