Job Description

Job Title: Medical Director - Clinical Transformation (Part Time)
Job ID: 733678
Status: Part-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Network Management
Location: 600 Grant St, Pittsburgh PA 15219

Description

UPMC is actively seeking a part time Medical Director - Clinical Transformation to support the UPMC Health Plan!

The Medical Director- Clinical Transformation will be responsible for ensuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. Maintains a working relationship with providers in the UPMC Value-based Reimbursement Program and provides on-going guidance and support to network providers related to quality improvement and clinical practice improvement opportunities. Reports directly to the Senior Medical Director for Value-based Care and Innovation and also works closely with other members of the Value- based Reimbursement team to develop a clinical improvement strategy that enables provider success in value-based reimbursement. Demonstrates an ability to connect with practicing providers, build and manage relationships, and establish bi-directional communication between network providers and UPMC Health Plan internal staff.

The ideal candidate for this position is a physician with subject matter expertise in value-based reimbursement programs and can provide strategic, hands-on support to Primary Care Partners by (1) analyzing and synthesizing Partner-specific performance data; (2) identifying targeted clinical opportunities for improvement; and (3) coordinating and implementing in collaboration with the Partner and UPMC Health Plan on Partner-specific clinical improvement strategies. The individual in this role must be able to work collaboratively in a matrixed environment, have strong inter-personal skills, be organized and self-directed, and enthusiastically represent the Organization and its mission and goals.


Responsibilities:

  • Maintains a working relationship with providers in the UPMC Value-based Reimbursement Program and provides on-going guidance and support to network providers related to quality improvement and clinical practice improvement opportunities.
  • Closely works with the Senior Medical Director for Value-based Care and other UPMC Health Plan Value-based Reimbursement team to review data, identify clinical opportunities specific, and develop clinical practice improvement opportunities specific to providers in the UPMC Health Plan Value-based Reimbursement Program.
  • Demonstrate enthusiasm and support for value-based payments and UPMC Health Plan’s goals in expanding this program and helping providers be successful practicing in a value-focused environment.
  • Daily activities support adherence to quality and utilization standards as it relates to supporting providers in UPMC Health Plan’s Value-based Reimbursement program. Establishes an effective working relationship between UPMC Health Plan's Network and its physicians, hospitals and other providers
  • Communicate and educate network providers regarding clinical guidelines, pathways, protocols, and standards related to quality and utilization processes with the aim of supporting providers in value-based reimbursement. 
  • Keep current with accepted standards and professional developments in the areas of quality improvement, population health, and utilization management.
  • Provide leadership and direction in meeting Quality Improvement and Care Management goals directed at improvements in member health status outcomes and established business strategies.

Qualifications

  • Doctor of Medicine or Doctor of Osteopathy from an accredited school.

    Licensure, Certifications, and Clearances:

         Doctor of Osteopathy or Medical Doctor


UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $0 to $0

Union Position: No

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