Medical Director
4 weeks ago
About the Job
Canopy Health represents an innovative Alliance of leading independent healthcare providers that is reinventing healthcare throughout the SF Bay Area. Formed in 2015 by UCSF, John Muir Health, Hill Physicians and Meritage Medical Network, Canopy holds a restricted Knox-Keene license and offers Commercial HMO, Medicare Advantage and EPO health plan products through partnerships with United Healthcare and HealthNet.
Through its unique provider-owned and managed model, Canopy champions seamless collaboration at unprecedented levels among its alliance partners as they work together to improve quality, drive affordability, and deliver a uniquely integrated, consumer-centric and transparent member experience. Since launching the Network in 2015, Canopy has more than tripled enrollment to 52k members, doubled its geographic service area to ten counties, expanded to over 30 hospitals and 70+ urgent care centers.
SUMMARY: The part-time Medical Director will work in partnership with the Chief Clinical & Innovative Officer (CCIO) and clinical and administrative team. S/he will work in collaboration with the clinical team to lead scheduled network and committee meetings and partner with UM and second level reviews. S/he will play a key role supporting the clinical team and CCIO on designing care management and population health interventions.
Monthly Commitment: approximately 8-10 hours
We are looking for candidates who live in the Bay Area.
How You Will Contribute:
- Lead scheduled meetings including work with clinical and administrative to create agenda, confirm speakers, finalize slide decks. Moderate meeting and engage stakeholders. Work with clinical and administrative team to summarize findings to inform future efforts (approximately 3-4 hours/month).
- Physician review for 2nd level reviews. Approximately 1-2 reviews requiring Medical Director attention per month. Complex cases that require interpretation of policies and guidelines such as DMHC, NCQA, Health plan medical necessity, etc. (approximately 1-3 hours/month).
- Partner with clinical team and CCIO on designing care management and population health interventions and addressing opportunity areas (approximately 1-3hours/month).
Must Haves:
- Active, unrestricted medical licensure in the State of CA and board certified in a specialty recognized by the American Board of Medical Specialties are required.
- Additional experience in CA or in a similarly mature managed care market characterized by capitated or other risk sharing contracts involving hospitals and medical groups/IPAs is highly preferred.
- At least two (2) years of experience working for one or more healthcare organizations (health plan, IPA, ACO, IDN).
- S/he will have demonstrated success implementing the innovative payment, care management, data system, and culture change reforms needed to succeed in an accountable care network.
Hiring Hourly Rate: $500/hour
Canopy Health provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, disability, genetics, gender, sexual orientation, age, marital status, veteran status. In addition to federal law requirements, Canopy Health complies with applicable state and local laws governing nondiscrimination in employment. 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.
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