Medicare Value-Based Care Director

Capital District Physicians Health Plan Inc; City of Albany (NY); On-site; USD 250,000 - 375,000; Full time

Job summary

Capital District Physicians Health Plan Inc. in Albany, NY, seeks a Senior Medical Director to lead clinical strategy and value-based initiatives, partnering with line of business leadership, network contracting, and analytics to improve outcomes and control costs.

The role requires an MD or DO with board certification and NYS license, plus 3+ years directing medical management in a health plan and experience with risk-based arrangements. Travel may be required.

Qualifications

• MD or DO degree with board certification and NYS license.
• 3+ years as Medical Director for a health plan or equivalent.
• Experience designing and supporting value-based payment models.

Responsibilities

• Serve as senior clinical advisor to line of business leadership on strategy, population health, quality and regulatory priorities.
• Translate data into actionable strategies and operating priorities to improve member outcomes and cost performance.
• Establish provider performance expectations, scorecards, and improvement strategies.
• Provide clinical leadership for medical management programs including utilization management, prior authorization, and care coordination.

Skills

Leadership in health plan

Value-based care experience

Analytical and financial acumen

Strong communication

MD/DO medical leadership

Education

MD/DO degree

Board certification

NYS Medical License

Job description

Capital District Physicians Health Plan Inc. in Albany, NY, seeks a Senior Medical Director to lead clinical strategy and value-based initiatives, partnering with line of business leadership, network contracting, and analytics to improve outcomes and control costs.

The role requires an MD or DO with board certification and NYS license, plus 3+ years directing medical management in a health plan and experience with risk-based arrangements. Travel may be required.