Market Medical Director

HCSC • Richardson, TX

1d

About The Position

The role of Market Medical Director (MMD) at HealthSpring Medicare Advantage requires a strong background in clinical practice, value-based care, healthcare economics, managed care, the Medicare Stars program, risk adjustment and with a passion for working alongside provider partners to ensure positive customer outcomes and experience are top priority. As a key member of the Market leadership team, the Market Medical Director will help to drive strategy and ensure clinical excellence in clinical programs, Stars, risk adjustment and total cost of care. The Market Medical Director will continue to strengthen partnerships with providers and health systems in the Market. They will work closely with Independent Physician Associations (IPA), health systems, aligned managed service organizations (MSO) and independent practices. The ideal candidate will have experience functioning within a matrix environment with a demonstrated ability to lead by influence.

Requirements

• Physician (M.D. or D.O) with a current and unrestricted physician license in a state or territory of the United States
• Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists
• 5 years of clinical experience
• Analytical and communication skills
• Strategic thinking skills
• Proficiency in computer skills (including software applications such as Microsoft Office Product and Lotus Notes) needed for electronic documentation of case reviews

Nice To Haves

• 3 years Managed Care experience
• MBA or equivalent experience preferred but not required.
• Experience with case management preferred
• Familiarity with fraud, waste, and abuse reviews a plus.
• Strong computer skills and technical independence.
• Data science background or Artificial Intelligence knowledge is a plus.

Responsibilities

• Drive strategy and ensure clinical excellence in clinical programs, Stars, risk adjustment and total cost of care.
• Strengthen partnerships with providers and health systems in the Market.
• Work closely with Independent Physician Associations (IPA), health systems, aligned managed service organizations (MSO) and independent practices.
• Function within a matrix environment with a demonstrated ability to lead by influence.

Benefits

• health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Ph.D. or professional degree