The Physician Lead (PL) serves as a leader to a team of clinicians in a designated market responsible for handling a variety of health-related problems and educating patients and their families on wellness, prevention, and early detection. The PL is responsible for executing the clinical strategy through the management of their own patient panel as well as those of the clinicians whom they lead.

The PL reports directly to the Market CMO and is directly responsible for

• Administrative oversight and outcomes determined by the Clinical / Operational Leadership of the Market
• Spend a portion of time clinically-focused on direct patient care, with the remaining time dedicated to administrative duties related to oversight of clinical provision of care including, but not limited to:

Working collaboratively with Market CMO and Operational Leadership to:

• Advance the Model of Care
• Create profit improvement initiatives
• Design operational implementations
• Contribute to the strategic intent

Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in:

• Maintaining Collaborative / Supervisory Agreements per state protocols
• Assisting with panel management
• Providing direct education to clinicians around clinical protocols / disease
• prevalence / appropriate levels of clinical quality care
• Providing guidance to individual clinicians about patient terminations, in
• collaboration with Compliance
• Supporting clinicians with schedule templates, coverage, daily issues
• Managing behavioral concerns of supervised staff
• Assisting with PTO Management
• Assisting with CME time and reimbursement requests
• Assisting with completion of performance reviews
• Assisting in resolution of inquiries, requests, and complaints from clinical staff
• Assisting in organizing team building activities
• Assisting in resolution of inquiries, requests, and complaints from patients
• Ongoing chart review / audit of clinical staff to ensure quality care and identifying opportunities for education/coaching
• Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management) to impact Part D per Member per Month (PMPM) costs while maintaining high quality care
• Optimizing network; preferred network specialists – contributing to the identification of preferred network specialists to optimized delivery of care for ongoing maintenance / cost saving opportunities
   

Making decisions related to the identification and mitigation of complex technical and operational problems within clinics/centers

• Managing financial / operational performance of their assigned clinics to ensure success
• Participating in provider committees (i.e. Technology Governance, EMR Optimization, etc.) and attending meetings regularly
• Participating in Shared Service Strategy Meetings
• Participating in quality improvement programs, population health programs, continuing education, and other patient care programs established by clinical requirements
• Assisting in recruiting and interviewing of potential clinical staff
• Participating in patient retention and marketing activities as required
• Serving as a community representative in the media and press activities

Other duties as directed by the Market CMO

• Maintaining confidentiality of all patient information according to both state and federal
  guidelines and regulations
• Maintaining medical history and medical records
• Ordering studies, tests and ancillary services
• Participating as a back-up on-call physician
• Prescribing medical treatment and clinical drugs to patients
• Referring patients to specialists as needed

Required Qualifications

• MD/DO
• 8 or more years of technical experience
• 2 or more years of project leadership experience
• Licensure requirements of the state of jurisdiction
• Graduate of accredited MD or DO program of accredited university
• Prefer Internal Medicine specialty
• Board Certification in Family Medicine, Internal Medicine or Geriatric Medicine
• This role is considered patient facing and is part of Humana/Senior Bridge's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Active and unrestricted DEA license
• Medicare Provider Number
• Medicaid Provider Number
• Minimum of three to five years directly applicable experience preferred
• 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
• Good understanding of best practice coding and documentation in value based environment
• Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results.
• Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
• Accountable: You meet clearly stated expectations and take responsibility for achieving results.
• Clinical Knowledge: You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs
• Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.

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Scheduled Weekly Hours

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Description of Benefits

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Equal Opportunity Employer

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.