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National Complex Care Medical Director

3 months ago

Scottsdale, Arizona, United States Equality Health Full time

Equality Health, LLC is a Phoenix-based whole-health delivery system focused on transforming value-based care delivery with population specific programs that improve access, quality, and member trust.

Our mission is to ensure diverse populations receive quality healthcare that improves and enriches their lives.

Through an integrated technology and services platform, culturally competent provider network and personalized care model, Equality Health helps managed care plans and health systems improve outcomes for diverse populations while simultaneously making the transition to risk-based accountability.


Position Summary:


As a National Complex Care Medical Director, you will play a pivotal role in transforming healthcare for our highest-risk, highest-need patients across our markets.

You will lead all clinical aspects of our complex care program. This program focuses on providing comprehensive, patient-centered care to individuals with complex medical, behavioral, and social needs.

Your responsibilities will include designing clinical programs, overseeing clinical teams, collaborating with primary care providers (PCPs) and specialists, and ensuring seamless clinical operations across our markets.


This position reports to the Chief Clinical Officer (CCO) to develop clinical policy, and interacts with network physicians, health plans, and key members of state regulatory bodies.


Responsibilities:

  • Clinical Program Design and Implementation:
  • Develop and iterate on evidence-based clinical programs tailored to complex patient populations
  • Design care pathways, protocols, and templates to guide clinical practice
  • Collaborate with cross-functional teams to integrate complex care seamlessly into our model
  • Clinical Oversight and Leadership:
  • Lead and mentor clinical teams responsible for managing complex patients
  • Ensure adherence to clinical guidelines, quality standards, and best practices
  • Foster a culture of continuous learning and improvement among clinical staff
  • Patient-Centered Care Planning:
  • Foster collaborative relationships with PCPs, specialists, and community resources to create and execute on holistic, whole-person care plans
  • Prioritize patient goals, preferences, and social determinants of health
  • Facilitate care coordination and communication across the care continuum
  • Quality and Performance Management:
  • Monitor and drive results related to clinical outcomes, utilization, and patient satisfaction
  • Implement strategies to improve quality, reduce costs, and enhance patient experience
  • Work closely with data analytics teams to track program performance
  • Stakeholder Engagement:
  • Build strong relationships with PCPs, specialists, health plans, and community-based organizations
  • Advocate for complex care within the healthcare ecosystem
  • Represent Equality Health in national forums and conferences as a thought leader

Competencies:
To perform the job successfully, an individual should demonstrate the following:

Adaptability - Demonstrates persistence and overcomes obstacles. Measures self against standard of excellence. Recognizes and acts on opportunities. Sets and achieves challenging goals. Takes calculated risks to accomplish goals.

Communications Possesses outstanding verbal and written communication skills with experience and expertise in public speaking.

Continuous Learning - Assesses own strengths and weaknesses. Pursues training and development opportunities. Seeks feedback to improve performance. Shares expertise with others. Strives to continuously build knowledge and skills.

Leadership - Exhibits confidence in self and others. Inspires respect and trust. Motivates others to perform well. Reacts well under pressure. Shows courage to take action.

Problem Solving - Develops alternative solutions. Gathers and analyzes information skillfully. Identifies problems in a timely manner. Resolves problems in early stages. Works well in group problem solving situations.

  • Impact & Influence - Achieves win-win solutions. Addresses divergent opinions. Displays ability to influence key decision-makers. Pursues and wins support for ideas. Uses authority appropriately to accomplish goals.

Required Knowledge, Education, & Experience:

  • Medical Degree (MD or DO): Board certification in a relevant specialty (e.g., family medicine, internal medicine, palliative care)
  • Graduate of an American or Canadian medical school accredited by the Accreditation Council for Graduate Medical Education (ACGME); or, equivalent training in a foreign medical school with successful completion of the ECFMG and FLEX examinations.
  • Active Board Certification in good standing.
  • Active and unrestricted licensure with no board sanctions or actions in the previous ten (10) years
  • Minimum seven (7) years of clinical practice in direct patient care; experience must include health plan and/or manage care experience.
  • Proven experience developing and implementing standards of care, medical protocols and quality assurance standards.
  • Direct experience in managing and operating complex care specific programs.
  • Exceptional communication, presentation, and interpersonal skills coupled with a demonstrated ability to effectively express complex technical and scientific concepts to a broad range of stakeholders.
  • Proven leadership in a matrix environment demonstrating critical thinking, deductive reasoning and decision-making skills.

Highly Preferred Skills, Abilities, & Qualifications:

  • Strong knowledge of Medicaid, Medicare, and Affordable Care Act.
  • Experience in working with diverse and underserved populations.
  • Able to effectively communicate and collaborate with physicians and surgeons in the network.
  • Able to establish collegial relationships with practicing clinicians in the network.
  • Prior experience with medical management policy and value-based care.
  • Demonstrate leadership ability and skills in critical thinking, strategic planning, analysis and systems thinking.


Equality Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.


This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.