Prospect Medical is searching for a qualified:
Regional Medical Director, CDI: Eastern Market
SUMMARY
Position
The Regional Medical Director of CDI will provide leadership to Prospect Medical clinicians and assist the Chief Medical Officer in implementation of Prospect’s strategic initiatives. The Regional Medical Director will partner with facility Medical Directors and will work collaboratively to ensure corporate goals are met and direct and integrate the activities of multiple and major projects to ensure projects are cohesive, consistent, and effective in supporting Prospect’s mission, goals, and strategic plan.
Responsibilities
• Represent the Office of the Medical Director in key meetings in the following areas: quality improvement, care management, risk management, peer review, utilization review, clinical outcomes, and health enhancement.
• Participate in review and improvement of the financial success of areas of responsibility.
• Encourage standardization across regions in areas of responsibility.
• Integrate the specialties to function in a cohesive fashion; aiding departments with institutional issues by working with hospital and health plan administrations.
• Interface with all local Medical Directors to develop and implement new business strategies, quality initiatives and lines of business.
• Participation in Compliance and other important training is a condition of employment.
• Foster a culture of measurement, performance, continuous improvement, accountability, service-orientation and exemplary team work.
• Participate in the mentoring and development of physician managers/leaders.
• Assist in the development, implementation and modification of compensation program and incentives aimed at aligning the interest of clinicians with the goals of the organization.
• Participate in the development and process for physician performance evaluation, physician reward and recognition, physician coaching, peer review and physician discipline.
• Oversee designated clinical programs, e.g. disease management, pharmacy, hospitalist program and behavior health.
• Participate in the development of clinical guidelines so that care is standardized across all regions and variation is minimized.
• Participate in the development and implementation of guidelines, protocols and care pathways pertaining to medical care for patients at Prospect Medical facilities.
• Participate in the development and implementation of medical quality standards and targets, and oversee the achievement of such targets.
• Participate in the credentialing and privileging criteria for physicians and advanced practitioners.
• Participate in the risk management program as well as the approval of malpractice claims.
• Represent Prospect Medical and participate in establishing strong and lasting relationships with patients, physicians, clinicians, health plans, and community organizations.
Requirements
• M.D. or D.O. degree, current and unrestricted license to practice medicine in the State of California.
• Certification by HCPRO (ACDIS, CCDS certification) or AHIMA (CDIP certification). CCDS and CCS certification preferable.
• Minimum 7 -10 years’ experience in a management role leading physicians in a hospital setting.
• Advanced degree in healthcare management and revenue audit a plus.
• Ability to present clearly and persuasively to physicians, staff, local and national PMH leadership.
• Excellent verbal and written communication skills.
• Must embrace and exemplify the core vision and values of Prospect Medical Holdings.
Knowledge of:
• Federal, state, and private healthcare compliance policies and regulations.
• Official coding guidelines, reporting guidelines and private healthcare criteria based guidelines.
• CMS (IPPS) final rules of healthcare policy makers and payers.
• Incentive based and claim based quality measures and HER meaningful use.
• Extensive knowledge and experience with ICD-10, CMS, and APR-DRG and experience in acute care hospital facility.
Interpersonal traits: Possess the highest degree of honesty, integrity and character. Possess traits of good judgment, confidentiality, and discretion in communicating with colleagues and constituents. Possess a high degree of emotional maturity; excellent interpersonal, verbal, and written communication skills with ability to work and communitive effectively across a variety of communication platforms to local municipal officials and staff. Have the ability to work independently yet collaboratively with PMH senior leadership in communicating issues to local officials and staff. Have the ability to professionally present materials and presentations to local municipal officials and staff. Proven track record of demonstrating core competencies of accountability and measurement, engaging and cooperative style, innovation and entrepreneurial spirit, commitment to quality and service.
If you are a qualified, high-achieving professional who wants to make a positive difference in the world of managed care, please submit your resume directly to:
Shawnee Mercier: National Director, Executive Recruitment Email: recruiting@prospectmedical.com
Quality Service, Quality Care…that’s who we are!
Please visit our website for more information and a listing of all of our open positions
www.prospectmedical.com