Medical Director
3 weeks ago
JOB SUMMARY
Dir Medical Director - BSWQA is responsible for planning, overseeing, and directing strategic medical affairs for Baylor Scott and White Health (BSWH), which may include patient care operations, patient quality, patient safety, infection control, risk management, joint ventures, physician networks, and medical credentialing functions. Works with facility in a matrix environment with diverse stakeholders and exercises influence in the absence of control. Establishes, implements, and communicates medical policies, practices, standards, protocols, and bylaws to ensure quality patient care for area(s) of responsibility within BSWH health care system, hospitals, clinics, and ambulatory care facilities. Aligns the views and goals of medical staff to the business objectives of BSWH. Ensures that the medical staff practices are compliant with all applicable legal, regulatory, and accreditation requirements. Leads, guides, and facilitates physician relations, recruitment, credentialing, and peer review activities. Evaluates new developments in medical care and recommends new practices and procedures. Consults with BSWH presidents, senior executives, medical staff, and clinical staff on medical issues and operational problems affecting patient care. Oversees, develops, and implements medical programs and initiatives to improve the medical service delivery and quality of patient care at BSWH. May guide and participate in the educational activities of medical staff including medical students and residents.
Consistent with the level of entity Director responsibility, a Medical Director translates and implements strategic plans and objectives for area of responsibility. Makes final decisions on operational matters and ensures achievement of objectives. Recommends policies and organizational changes for area. Plans and executes projects and initiatives that meet annual objectives. Plans and directs the operations of a department or area, with responsibility for staffing, processes, budgets, and costs of the unit. Leads and advises subordinate(s) to meet schedules, resolve technical problems, and monitor performance. Has a larger, more complex organization or functional area than a manager. May have one or more managers or supervisors reporting to the role.
ESSENTIAL FUNCTIONS OF THE ROLE
1. Directs medical affairs for assigned area of Baylor Scott and white Quality Alliance (BSWQA).
2. Recommends and implements clinical strategic and operational plans aligned to BSWH overall business objectives.
3. Excels at executive level internal and external presentation skills.
4. Engages and consults with service line operational leaders as well as employed and independent providers on value-based care approaches and programs.
5. Directs medical programs for care management, quality improvement, and clinical performance.
6. Applies clinical experience and expertise to BSWQA strategies and initiatives to drive performance across diverse payer contracts, but with focus in commercial and employer facing business.
7. Assesses clinical operations, makes recommendations, executes changes, and monitors clinical effectiveness.
8. Leads activities that engage providers with clinical and cost data, contract measures, adoption of clinical guidelines, and reduction of clinical variation.
9. Directs the development of new policies, procedures, protocols, and standards related to physician practice.
10. Evaluates and implements quality and efficiency improvement activities and effectively communicates changes.
11. Ensures compliance with all applicable laws and regulatory requirements and may serve as consulting physician for state and federal medical management regulatory audits.
KEY SUCCESS FACTORS
1. Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) required. MBA or MHA preferred.
2. Minimum 5 years as a physician in clinical practice.
3.
Prior health system or payer experience with directing/supervising care management.
4. Experience aligning and leading the medical operations within a healthcare system, preferably including program growth, practice acquisition, technology implementation, process improvement, and regulatory compliance.
5. Current and unrestricted license to practice medicine in the state of Texas (or eligibility to obtain one).
6. Current certification by the appropriate certifying board (including satisfaction of current maintenance of certification).
7. Informative and persuasive presentation skills.
8. Solid clinician skills and population health acumen including understanding of risk management, managed care contracting, national benchmarking, and related quality metrics.
9. Knowledge or experience with Texas medical landscape.
QUALIFICATIONS
Education: MD or DO
Experience:
5+ years experience practicing medicine
2 + years payer/insurance experience
2 + years employer-facing or health system population health management experience
Certificates, Licenses and Registrations: Active medical license and eligibility for Texas license, Current ABMS Medical Board Certification.
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