Medical Director

Location: Hybrid (Boston)

Job Summary:

The Medical Director has strategic and operational responsibility for the clinical effectiveness and implementation for the organization's Value-Based Model of Care as well as for a suite of shared initiatives and services that are built and offered to health centers. They will work under and with the Chief Medical Officer (CMO) to achieve the organization's targets on annual quality of care, total cost of care savings, innovation, value-based care, and growth opportunities throughout the organization's business line. This role will include strategic insight and contribution to the clinical program strategy. The medical director will also work across the organization with colleagues in units including quality, innovation, risk-adjustment, Medicare and Medicaid-specific strategies, policy, care management, and other areas. They will also partner with CMOs and clinical leaders at C3 FQHCs to ensure that C3's strategy and implementation are responsive to local community needs and health center capabilities in order to maximize the success of individual health centers and C3 as a whole. Successful candidates will be comfortable and adept working across a multi-matrixed organizational structure with use of both direct and indirect influence on projects, while working to partner with a heterogenous set of health center stakeholders. The medical director serves as a key organizational leader and models collegiality in everything they do, including in interdepartmental workings.

Responsibilities:

• Stays current with evidence-based best practices and innovations in healthcare delivery, primary care, and emerging technologies that result in improved outcomes, patient and provider satisfaction, and lower total medical costs; and brings those insights to the continued evolution of the organization's strategy. This includes comfort with changing delivery models and challenges arising from fast-moving technological changes
• Serves as a partnered strategist and proponent for the development and implementation of programs, services, and performance standards related to the implementation of the organization's clinical strategies, including strategies to iterate on health center-specific programs. This work includes strategies to improve quality, patient, and provider outcomes and to effectively manage total cost of care for C3. Such efforts will include work in our subsidiaries, Community Technology Cooperative and Community Pharmacy Cooperative, and new other emerging lines of business including those in Medicare, commercial insurance, and medical education
• Works across the organization to ensure a person-centered, holistic, non-medicalized approach to assessment, quality initiatives, care planning, and all aspects of the patient-facing care and its implementation
• Collaborates closely across multiple teams and layers of leadership, including operations, clinical operations, quality, innovation, IT, analytics, policy and finance, to ensure the effectiveness of clinical initiatives, identify gaps in clinical programs and clinical strategy, and provide leadership on the development of new clinical initiatives. Projects served will include both those with direct and indirect influence in a multi-matrixed framework
• Provides key analytic interpretation and insights into clinical and cost trends to identify areas where interventions may generate significant improvement, and collaborates with the CMO to develop, prioritize, implement, and monitor interventions
• Provides direct and indirect coaching on successful value-based care structures and strategies to both internal staff and health center leadership teams
• Based on observation, on-the-ground quality improvement experience, outcomes, evidence-based background, and industry know-how, provides input on quality improvement and innovation strategies and provides implementation support into those activities
• Provides direct support where needed to the clinical operations team for consultation on challenging care coordination cases, as well as ability to partner with the team to interface with treating providers at health centers
• Works collaboratively to perform root cause analysis when issues arise
• Formulates and executes plans to course correct
• Participates as a key partner to the National Strategy Team inclusive of developing value-based payment opportunities for health centers outside of Massachusetts, and attends out-of-state meetings via Zoom and/or in person as needed
• Participates as a key partner to in-state health centers inclusive of periodic, regular meetings via Zoom and in-person with travel to relevant health centers
• Supports interested health centers in understanding how C3 can support health centers, in a manner that is situationally and geographically astute
• Serves as a clinical leader, inside and outside of the company
• Serves as a trusted advisor and partner to the C3 CMO, health center CMOs, other health center clinical leaders, and to provider ecosystem partners such as hospitals, and colleagues in state and federal government
• Serves as a thought partner, leader, and implementation support in efforts to address clinical workforce issues, inclusive of efforts to build, expand, and sustain clinical workforce at health centers
• Collaborates with policy staff to provide input on and develop organizational responses to proposed regulatory changes
• Partners with colleagues on EMR, pharmacy, and risk adjustment optimization efforts. This would, for example, include clinical partnership with clinical and non-clinical risk adjustment colleagues, and input and triage into improving EMR workflows and data and interoperability efforts in a manner that is collaborative and focused on problem-solving
• Develops relationships, sets shared goals, and holds health center and ecosystem partners accountable in working toward shared goals
• Communicates enthusiasm for the mission of C3 and the opportunity that the ACO represents for FQHCs to be successful in value-based care and serve their communities even more effectively and shares this message with both internal (e.g. C3 FQHC) and external audiences
• Supports the CMO and members of the Executive Team in analyzing, recommending, shaping, and/or monitoring changes in reimbursement rates, networks, payment policies, benefits, utilization management, and any other changes in the "rules of the road" associated with the execution of the organization's strategy
• Supports the CMO and other team members in standing up novel new programs for value-based care in the organization's portfolio
• Collaborates with health center CMOs to gather information related to common issues and representing policy concerns to the Massachusetts Executive Office of Health and Human Services (EOHHS), the Centers for Medicare and Medicaid Services (CMS), or other similar bodies in coordination with the CMO and/or other Chiefs
• Serve as supporting staff for the Board Quality Committee including, where needed, developing and presenting content for the Committee, and working with the respective board chair. Also serves as member where needed on other clinical committees
• Documents board decisions related to financial and strategic matters including the development of policies
• Together with colleagues and other senior leaders, fosters a culture (through example as well as influence) of constructive and solution-oriented collaboration to define plans of operation as this growing and fast-moving organization continues to take on new challenges, business and changes in scope and priorities
• Is a supportive thought partner to all colleagues
• Strikes a good balance between, on the one hand, appropriately advising operational teams and pushing for proactive and lower operational risk, and on the other hand having a "can do" approach to inevitable evolution and expansion in the organization's scope
• Other duties as assigned
• This role is expected to balance C3 duties and some form of active clinical practice at a C3 FQHC site, likely at the 80/20 ratio. Candidates will be expected to conduct their clinical practice at a C3 health center site utilizing the suite of support tools provided by the ACO (including centralized EMR and quality and care coordination suites)

Required Skills:

Must possess strong clinical, strategic, collaboration and communication skills, along with practical skills in developing, measuring, and modifying programs to achieve goals in a value-based care context.

• Experience working in or with Federally Qualified Health Centers
• Experience with alternative and value-based payment models
• Experience leading successful change in one or more clinical settings
• Experience with on-the-ground quality improvement efforts
• Experience with behavioral health and the needs of marginalized, aging, and disabled populations is also preferable
• Experience at the intersection of information technology and clinical care, and care team design/redesign which is relevant to the implementation of value-based care systems
• Skilled in exercising a high degree of initiative, judgement, discretion, and decision-making to achieve objectives
• Strong track record of working in multidisciplinary teams that share and leverage the strengths of their members
• Track record of managing a team of direct and/or indirect administrators; engaging and developing staff
• Strong communication and persuasive skills
• Must be able to remain in a stationary position 50-75% of the time

Desired Other Skills:

• Familiarity with the MassHealth ACO program and/or other state Medicaid programs
• Familiarity with Medicare ACO programs and other commercial programs
• Experience with anti-racism activities, and/or lived experience with racism

Qualifications:

• Medical degree, MD or DO, required or advanced practice-equivalent alongside appropriate years of experience required
• 3-plus years of management in clinical, consulting, health plan operations, provider practice or hospital leadership or equivalent