Medical Director for Renal Care

4 weeks ago

Jacksonville, Florida, United States Monogram Health Full time
Job Summary

We are seeking a highly skilled Medical Director to lead our renal care team at Monogram Health. As a key clinical leader, you will contribute to the development and oversight of clinical strategies, policies, and programs that drive improved patient health outcomes.

Key Responsibilities
  • Oversee the delivery of care management services within your market, ensuring high-quality, consistent, and compliant patient care.
  • Utilize IT and data tools to report, monitor, and improve quality and utilization.
  • Conduct retrospective reviews of hospitalizations and dialysis treatment episodes to ensure Monogram's care management services are effectively rendered.
  • Develop and implement clinical strategies, evidence-based clinical care guidelines, and care management programs for effectiveness and efficiency.
  • Reduce unnecessary episodes of care, including hospital readmissions.
  • Prepare clinical care reports in a timely fashion.
  • Apply evidence-based criteria to determine the appropriate care and lead case rounds with nurse practitioners and care managers.
  • Analyze data to build member care plans and ensure care goals are achieved.
  • Identify quality of care issues for health plan clients.
  • Optimize patient health outcomes and total performance against health plan contracts.
  • Represent Monogram as a clinical leader to health plans, providers, and other organizations.
  • Oversee the clinical elements of the day-to-day execution of care management and practice operations within your market.
  • Achieve clinical metrics and goals for delivering improved health outcomes at a lower total cost of care.
Requirements
  • Demonstrated experience applying evidence-based clinical criteria.
  • Experience in renal care and geriatrics.
  • Strong management and communication skills.
  • Active, unrestricted state medical license required in each state within the market.
  • Experience with high-need Medicare Advantage and managed Medicaid populations.
  • Experience with NCQA, HEDIS, Medicaid, Medicare, quality improvement, medical utilization management, and risk adjustment.
  • Current state medical license without restrictions to practice and free of sanctions from Medicaid or Medicare. Willingness to become licensed in multiple states.
  • MD (Medical Doctor) or DO degree from an accredited medical school.
  • BC or BE in an ACGME-approved specialty such as Nephrology, Internal Medicine, Family Practice, Emergency Medicine, Critical Care, Cardiology, Endocrinology, Hepatology, or Geriatrics.
Benefits
  • Opportunity to work in a dynamic, fast-paced, and innovative value-based provider organization that is transforming the delivery of kidney care.
  • Competitive salary and opportunity to participate in the company's bonus program.
  • Comprehensive medical, dental, vision, and life insurance.
  • Flexible paid leave and vacation policy.
  • 401(k) plan with matching contributions.

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