Position Summary: A great opportunity to work directly with a dynamic all physicians Board of Directors and talented management team to support the clinical needs of the fastest growing IPA in the Central Valley serving Fresno and Madera Counties. Under the supervision of the Chief Executive Officer, the Medical Director is responsible for medically advising and supporting patient care teams of physicians, mid-level providers, and nurses participating in the IPA provider network in collaboration with Conifer Health Solutions the contracted management services organization (MSO).
The IPA currently has over 13,000 enrollees, 900 providers and partners with Saint Agnes Medical Center, Madera Community Hospital and Valley Children’s Hospital. In addition to partnering with all the major health plans, MedPRO starting in 2021 will be providing all the professional services for the new Central Valley Health Plan through the Department of Managed Health Care, as Restricted Knox Keene Plan. Further, in 2021-2022 MedPRO will launch a new Messenger Model Provider opportunity with competitive PPO products.
1. Provide medical direction and administration including, but not limited to, developing clinical practice and utilization guidelines, quality assurance measures, Hedis and Star goals and objectives, with direct communication to provider practices.
2. Prepare and deliver reports for the Management Team, Governing Board and supporting committees and work groups, such as the Utilization Management and Quality Committee.
3. Perform quality assurance activities.
4. Interact with contracted Health Plans, their Medical Directors, and associated utilization and quality assurance staff.
5. Participation advisory and training meetings with participating providers and staff.
6. Work in coordination with hospital medical directors, hospitalist providers, emergency room physicians to optimize tertiary care and utilization patterns.
7. Establish linkage with pharmacy, dental care, and community referral entities, social support resources to improve and expand the scope of serves available through community referrals.
8. Work with primary care, specialty care and ancillary providers and Conifer MSO to address ensure high quality IPA/MSO service delivery and training.
9. Establish positive and effective working relationships with local medical community specifically: network providers, Saint Agnes Medical Center, Madera Community Hospital, Valley Children’s Hospital, contracted FQHC’s and Central Valley Health Plan.
1. Skill in providing excellent customer service and support; organize and prioritize workload and meet deadlines; and excellent written and verbal communication.
2. Ability to interact effectively and professionally with persons from diverse cultural, socioeconomic, education, racial, ethnic and professional backgrounds.
3. Ability to work effectively with managers, co-workers, members of the public and professional groups.
4. Ability to communicate effectively, clearly, concisely with others (internal and external customers, both verbally and in writing), consistently demonstrate positive/proactive customer service attitude. Consistently maintain ethical behaviors exemplary of quality public service and fair standards, inclusively, among all employees and members of the public.
5. Ability to work as an effective team member and interact on regular basis with remote employees; function independently, exercise sound judgment and initiative; be flexible to shift priorities; maintain confidentiality; establish and maintain effective interpersonal work relationships, effectively assist providers; work toward goals and objectives of draft priorities.
6. Ability to follow DMHC, Health Plan and CMS practice guidelines. Should have a thorough understanding of utilization management, quality programs, peer-review, and clinical guidelines.
7. Ability to deliver constructive feedback including evaluation of provider’s productivity and practice attributes.
8. Other duties as assigned, including but not limited to participation on clinical committees, providing education, Quality Review and/or other activities.
9. Must be computer literate with ability to pull, analyze and compile various clinical reports.
10. Must be able to read, write and speak English. Bilingual is a plus.
Education and/or Experience:
Preference will be given to work experience in a public health or community clinic setting, previous work experience as a Medical Director, completion of an accredited primary care residency program, or Board Certification (or eligible) in Family Medicine or Internal Medicine.
Current licensure as an MD/DO to practice in the State of CA by the State Board of Medical Examiners.
Must be willing to travel locally on as needed basis.
Primary Location: Fresno CA, service area Fresno and Madera Counties
Job Type: Part Time (hourly or by arrangement). Must be available during regular business hours.
Shift Type: Days
Compensation: To be determined
Submit Confidential Letter of Interest and detailed Qualifications to:
Roger Gong M.D. President
Board of Directors
ATT: J. Michael Gallagher, Chief Executive Officer
Central Valley Medical Providers, Inc.
1303 E. Herndon Ave. MS 840
Fresno CA 93720
For more information please contact:
J. Michael Gallagher, Chief Executive Officer 559-999-2195
Anugeet Aujla, Chief Operating Officer 559-999-4944; firstname.lastname@example.org
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