Senior Regional Medical Director (Fortify)

GENERAL SUMMARY

The Senior Regional Medical Director (Fortify) serves as the primary conduit to a region of Fortify Children's Health (FCH) network practices and from time to time to additional regions of network practices as directed by the Medical Director (Fortify) or Executive Director, Fortify. This position is responsible for provider training and engagement, patient outreach and care management, quality initiatives, family and community engagement, and network operations for assigned practices. The senior regional medical director will lend leadership and medical/clinical expertise to support clinical compliance and analytics needs to ensure network success. Reports to the Medical Director (Fortify).

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Practice Engagement
  • Provider Training and Engagement
    • Provides clinical and operational support at the practice level to maximize engagement in the mission and vision of FCH.
    • Monitors quality performance at the practice level to ensure successful quality outcome measures for FCH.
    • Validates practice scorecards and outreach sheets.
    • Actively work eligibility and attribution issues identified in HealtheIntent.
    • Translates and utilizes analytic data to promote performance improvement at the practice level.
    • Intervenes with laggard practices in the region to promote overall network success.
    • Trains and supports clinicians in the use of HealtheIntent, including those who are new to the Fortify network.
    • Develops trusted and transparent relationships with the regional FCH champions.
    • Maintains open and meaningful communication channels between FCH and assigned practices.
    • Provides on-going education to assigned practices that enhance their understanding, and promote the adoption of value-based care.
    • Makes a significant contribution to the monthly key messages.
    • Active member with rotating leadership of the Clinical Care Committee.
  • Patient Outreach and Care Management
    • Works with the Director of Clinical Operations on the building, testing and implementation of an enhanced care management documentation platform.
    • Under the supervision of the Medical Director (Fortify), provides clinical guidance on components of the care management services program and documentation platform that impact the patient experience.
  • Quality Initiatives
    • Active member with leadership support of Quality Clinical workgroups as determined by Medical Director (Fortify) in alignment with clinical priorities.
    • Leads and/or coordinates quality improvement projects in the region, including the development of applications for MOC credit.
• Network Support
  • Clinical Compliance Oversight
    • Ensures FCH clinical compliance related to Utilization Review Accreditation Commission ("URAC"), and other accreditation agencies/bodies as necessary.
    • Ensures network-wide participant compliance with FCH clinical policies.
    • Supports network-wide quality improvement projects, including Maintenance of Certification work.
    • Provides clinical support for identified grant opportunities as directed by Medical Director (Fortify).
    • Performs other clinical compliance duties as assigned.
  • Clinical-Analytics Liaison and Support
    • Provides clinical perspective to analysts working on reporting projects and dashboards prioritized by clinical care team leadership.
    • Drives design of dashboards from a clinical end-user perspective, to include:
      • Attends scoping meetings where appropriate as assigned and prioritized by clinical care team.
      • Meets regularly with analysts to review progress and provide feedback.
      • Testing of dashboards.
    • Provides clinical validation of participant electronic health record (EHR) data to include:
      • Executes data profiling review.
      • Attends meetings with Director of Clinical Informatics to review and provide feedback to practice, EHR vendor, and Oracle Cerner.
      • Reviews discrepancies between EHR by extract comparison reports.
      • Previews measure-level validation reports.
      • Performs validation with practice.
      • Drives design and development in collaboration with data analysts of automated / ongoing EHR validation and quality control dashboards.
• Provides clinical validation of contracted payor data and other Fortify data as needed.
• Performs other clinical analytics support duties as assigned.
• Performs all other duties as assigned.

LICENSES AND/OR CERTIFICATIONS

• Required Licenses and/or Certifications
  • Active Medical Doctor (M.D.) or Doctor of Osteopathic Medicine (D.O.) Virginia license required.
  • American Board of Pediatrics or Family Medicine certification required.

MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS

• Required Education and Experience
  • Doctoral degree (M. D., Doctor of Medicine or D.O., Doctor of Osteopathic Medicine) required.
  • 5+ years of clinical experience in pediatrics field required.
• Preferred Education and Experience
  • Quality improvement experience or training preferred.
  • Familiarity and/or experience in value-based care preferred.
  • Prior experience in working with analytic data preferred.
• Required Knowledge, Skills and Abilities
  • Proficiency and technical aptitude in the use of a population health IT platform/environment.
  • Knowledge and understanding of the regional pediatric and family medicine practices as well as regional community resources.
  • Knowledgeable of high technical and functional aptitude for problem solving and critical thinking.
  • Demonstrated teamwork and team leadership skills with the ability to lead cross-functional teams.
  • Strong organizational skills with strong attention to detail and a commitment to accuracy.
  • Must possess strong verbal, written, and interpersonal skills.
  • Must be self-directed, self-motivated and have a high level of personal initiative.
  • Excellent time management skills with the ability to prioritize multiple and competing tasks, ability to shift priorities and able to work independently in a fast paced, fluid environment.

WORKING CONDITIONS

Normal office environment with little exposure to excessive noise, dust and temperature.

PHYSICAL REQUIREMENTS

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BLOOD BORNE PATHOGEN (BBP) EXPOSURE CATEGORY

No