With over 6,600 primary care and specialist physicians to serve our 600,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in 6 states: California, Texas, Rhode Island, Arizona, Pennsylvania, and Connecticut. Locations in California include Los Angeles, Orange County, Riverside County, San Diego, and San Bernardino County. Our extensive care services range from primary care and specialty physician services to acute care hospitals and skilled nursing facilities to behavioral health and wellness services.

The Clinical Operation, Medical Director is responsible for the clinical leadership and supervision of the physicians and advanced practice professionals (APPs) that provide direct clinical services to PMS and PMCA members both in the residential and office settings. Responsibilities include facilitation of evidence-based, cost-effective professional and institutional services to our membership through oversight of the day-to-day operations as well as mentoring and assisting in the training of physicians and APPs to ensure compliance with legal and requirements. This position chairs and/or participates in various committees to support performance improvement, improve quality of medical care and the physician and patient experience - including, but not limited to oversight of peer review and risk management. This position collaborates with the non-clinical administrative teams to optimize patient care and outcomes, including coordinating schedules, grievances, and appeals, negotiating physician contracts, etc. This physician engages physicians to promote relationships and alignment with the organizational goals.

Job Responsibilities/Duties

• Works proactively and collaboratively across the organization to ensure overall business objectives are met and supported.
• Promotes system-wide efforts to improve the quality of care to all patients through physician education and relationships.
• Collaborates with team members in the development, implementation, management, monitoring, and evaluation of the effectiveness of initiatives to achieve goals and improve the care provided to members.
• Participates in clinical decision-making in forums such as interdisciplinary care team meetings where a provider is involved in the care of a member.
• Collaborates with multiple departments on incentives, metrics, clinical programs and training that will improve the quality of care provided to our members along with decreasing costs.
• Attends various meetings and participates on committees as appropriate contributing ideas for improving efficiency, productivity, and member satisfaction.
• Participates in strategic planning and the annual budgeting process.
• Oversees the clinical decision-making of the C@H Case Management Teams with a focus on adherence to best practices and value-based care utilizing software or other systems for disease management, risk stratification, and predictive modeling.
• Directs the high-risk patient care team for NGMG in their management of complex members and implement processes to support end-of-life care as well as appropriate utilization of hospice and palliative care services.
• Reviewing a subset of APP charts for coaching and mentoring.
• Call schedule – in conjunction with PMCA and C@H administration. Be the backup and/or final go to for on-call when the on-call providers are not available.
• Responsible for content of physician meetings and trainings (with PMCA/C@H administrative input).
• Participate in strategic planning for PMCA/C@H including annual budgets.
• Assist National CMO, in conjunctions with PMCA administration in implementing Value base Care Initiative in a clinic setting.
• Supervising all providers (Physicians and APPs) - including interviewing, hiring, training, performance reviews (quality metrics, productivity, patient satisfaction), and disciplinary actions.
• Negotiating and maintaining PMCA and C@H Provider employment agreements.
• Reviewing and responding when needed for provider grievances/complaints received from patients, IPAs/HPs, and social media.
• Participating in all IPAs JOCs - in conjunctions with PMCA administration
• Be the clinical liaison between CAH and the referring physicians, specialists, hospitalists, and ancillary entities ( hospice, HH, etc.).
• Developing PMCA and C@H clinical KPIs (MLR, quality measures, Admissions, Hospice Referrals, etc.), tracking trends and conducting RCA, and implementing improvement plans.

Qualifications

Required Education/Experience

• Licensed, board-certified Medical Doctor in the State of California

• 3+ years of office-based clinical care experience

• 3+ years of Residentialists care—home health, home palliative care

• Some experience in medical leadership or oversight responsibilities preferred

Preferred Education/Experience

• Board Certified

Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals, benefit eligible positions will receive:

• Company 401K
• Medical, dental, vision insurance
• Paid time-off
• Life insurance

How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www.eeoc.gov/