Medical Director, Value Based Care

Upperline Health•Bowling Green, KY

22h•Hybrid

About The Position

Upperline is seeking a Medical Director, Value Based Care (VBC) to join the clinical leadership team in developing, implementing, and growing our unique value-based care model in Kentucky. The VBC Medical Director will serve as a clinical leader partnering with Operations and Population Health leaders to deliver successful value-based care results across the market.

Requirements

Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.)
Board certified in Internal Medicine, Family Medicine, Preventative Medicine, or Geriatrics
Active license in Kentucky and willing to pursue multi-state licensure if needed
~ 5 years of outpatient practice experience
Clinical leadership experience in a VBC or Population Health company
Experience with managed care and familiarity with payer-provider collaboration
Owned or been part of creating, improving, and/or implementing clinical processes, protocols, or evidence-based guidelines
Experience or exposure to rolling out and/ or managing VBC programs (e.g. Transitional Care Management, Complex Care Management, ED Diversion, Advanced Care Planning, High Risk Patient Outreach)
Talent for synthesizing information and solving complex problems; can independently translate high-level goals into actionable plans
Proven leadership skills and servant leadership mentality with a passion for people and culture
Ability to communicate, collaborate and work effectively with staff, providers, and organizational leaders
Self-starter with a bias for action orientation; demonstrates a service excellence mindset
Exceptional organizational and project management skills and the ability to prioritize and multi-task autonomously
Comfortable working in Excel; able to analyze data and present findings
Must be willing and able to routinely visit clinics and providers within the region; Residing in the market is strongly preferred

Nice To Haves

Fellowship training in Geriatrics and/or other advanced degrees (e.g., M.B.A., M.P.H., M.H.A.) valued but not required

Responsibilities

Oversee the care management and medical management of the Upperline Plus patients being seen by Upperline’s Nurse Practitioners in the in the market or region
Responsible for supervising medical management of patients in the region including clinical quality review of providers and serving as the collaborating physician for APPs in the region (as necessary based on state law)
Accountable for value-based care outcomes (e.g., ADK, total cost of care), medical management, care management, utilization management, and quality improvement tools and processes in the region
Manage and drive value-based care initiatives with APPs and doctors ensuring positive impact on patient outcomes
Analyze population health data and identify gaps and develop solutions to improve delivery of care, decrease hospitalizations and reduce medical costs
Educate providers on value-based care metrics and best practices and foster a culture that prioritizes accountability around outcomes-based performance
Ensure the region is meeting VBC operations metrics such as addressing Quality gaps, accurate documentation, patient engagement and retention
Design, implement and manage new value-based care programs and service lines in collaboration with population health and operations teams
Conduct interdisciplinary team meetings to discuss management of the most complex patients (including high cost and high-risk patients
Establish and maintain relationships with VBC team, specialists, and PCPs in the region; educate on Upperline Plus program and advocate for collaborative partnerships benefiting patients
Support onboarding and training of new providers and provide onsite and virtual clinical coaching and feedback with a focus on ensuring consistency and continuous improvement of managing patients more efficiently
Build relationships in the region and identify best partners (e.g., other specialists, home health agencies, hospitals) for Upperline to send referrals when needed
Develop clinical compliance guidelines and protocols