Senior Medical Director (Medicare)Primary Location: New York, New York
Additional Locations: CT-Hartford, FL-Jacksonville, FL-Sunrise, FL-Tampa, GA-Atlanta, IL-Chicago, MA-Boston, MD-Baltimore, MO-St Louis, NJ-New Brunswick, NJ-Princeton, NY-Albany, PA-Blue Bell, PA-Harrisburg, PA-Philadelphia, TX-Dallas, TX-Houston, VA-Richmond Apply
Specific areas of work include:
·Developing and implementing approaches to leverage clinical information to improve health care quality and outcomes.For example, collaborating with teams to integrate clinical information into algorithms that identify members for care management and making actionable clinical information available to provider partners (e.g., physicians, nurse practitioners, etc.)
·Optimizing the In-Home Assessment (IHA) Program in which clinicians complete an annual comprehensive assessment with members in their homes to improve clinical and Stars performance
·Optimizing all processes aimed at accurately and thoroughly documenting chronic conditions and submitting information to CMS.
·Developing educational materials and educating providers on how to accurately and thoroughly document chronic conditions.
·Participating in audits initiated by external bodies related to the documentation of chronic conditions
·Responding to information requests from Medicare market business and clinical leaders pertaining to the aforementioned bodies of work
·Providing clinical expertise and business direction in support of creating or enhancing additional medical management programs as requested
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