Care Management Medical Doctor
2 weeks ago
For a complete understanding of this opportunity, and what will be required to be a successful applicant, read on.
The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value based care provider focused on quality of care for the patients we serve. Our care team consists of Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators and more. Our approach allows us to provide an unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes for seniors by providing a concierge experience, multidisciplinary services, coordinated care supported by analytics and tools, and deep community relationships. Evaluates and treats center patients in accordance with standards of care.
· Follows level of medical care and quality for patients and monitors care using available data and chart reviews.
· Assists in the coordination of patient services, including but not limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care.
· Acts as an active participant and key source of medical expertise with the care team through daily huddles.
· Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in practice by displaying a professional and approachable demeanor.
· Completes all medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity.
· Follows policy and protocol defined by Clinical Leadership.
· Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.
· Participates in potential growth opportunities for new or existing services within the Center.
· Participates in the local primary care “on-call” program as needed.
· Spend 100% of your time clinically focused on direct patient care, inclusive of patient facing time and general administrative time (charting, meetings, etc.) as it relates to direct patient care.
Current and unrestricted medical license or willing to obtain a medical licenses in state of practice; Graduate of accredited MD or DO program of accredited university
Fully engaged in the concept of “Integrated team based care” model
Willingness and ability to learn/adapt to practice in a value based care setting
Basic computer skills, including email and EMR
Board Certification or Eligible to become certified (ABMS or AOA) in Family Medicine, Internal Medicine or Geriatric Medicine preferred
Medicare Provider Number
Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value based relationship environment
Knowledge of Medicare guidelines and coverage
Knowledge of HEDIS quality indicators
Guaranteed base salary + bi-annual bonus
~ Excellent benefit package – health insurance effective on your first day of employment
~ Life Insurance/Disability
~ Paid Time Off/Holidays
~ The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. This incentive opportunity is based upon company and/or individual performance.
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Conviva Care Centers provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of Humana’s Primary Care Organization, which includes CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.
NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status . It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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