Medical Director, Value Based Care

Upperline Health

$200K — $250K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • M.D. or D.O. with active South Carolina medical license
  • Board certified in relevant specialties (Internal Medicine, Family Medicine, etc.)
  • 5 years of outpatient practice experience
  • Clinical leadership experience in value-based care or population health
  • Experience with managed care and payer-provider collaboration
  • Proven track record in creating and implementing clinical processes
  • Strong analytical skills, particularly in data analysis and problem-solving

Responsibilities

  • Oversee care management for Upperline Plus patients served by Nurse Practitioners
  • Supervise medical management, ensuring clinical quality reviews
  • Drive value-based care initiatives to improve patient outcomes
  • Analyze population health data to identify gaps and propose solutions
  • Educate providers on metrics and best practices for value-based care
  • Implement new service lines in collaboration with operations teams
  • Facilitate interdisciplinary meetings for complex patient management

Benefits

  • Comprehensive medical, dental, and vision insurance
  • 401K retirement plan
  • Paid time off (PTO)
  • Parental leave support
Full Job Description
ABOUT THE MEDICAL DIRECTOR, VALUE BASED CARE

Upperline is seeking a Medical Director, Value Based Care (VBC) to join the clinical leadership team in developing, implementing, and growing our unique value-based care model in the Myrtle Beach, SC market. The VBC Medical Director will serve as a clinical leader partnering with Operations and Population Health leaders to deliver successful value-based care results across the market.

What You'll Do
  • Oversee the care management and medical management of the Upperline Plus patients being seen by Upperline's Nurse Practitioners in the in the market or region
  • Responsible for supervising medical management of patients in the region including clinical quality review of providers and serving as the collaborating physician for APPs in the region (as necessary based on state law)
  • Accountable for value-based care outcomes (e.g., ADK, total cost of care), medical management, care management, utilization management, and quality improvement tools and processes in the region
  • Manage and drive value-based care initiatives with APPs and doctors ensuring positive impact on patient outcomes
  • Analyze population health data and identify gaps and develop solutions to improve delivery of care, decrease hospitalizations and reduce medical costs
  • Educate providers on value-based care metrics and best practices and foster a culture that prioritizes accountability around outcomes-based performance
  • Ensure the region is meeting VBC operations metrics such as addressing Quality gaps, accurate documentation, patient engagement and retention
  • Design, implement and manage new value-based care programs and service lines in collaboration with population health and operations teams
  • Conduct interdisciplinary team meetings to discuss management of the most complex patients (including high cost and high-risk patients)
  • Establish and maintain relationships with VBC team, specialists, and PCPs in the region; educate on Upperline Plus program and advocate for collaborative partnerships benefiting patients
  • Support onboarding and training of new providers and provide onsite and virtual clinical coaching and feedback with a focus on ensuring consistency and continuous improvement of managing patients more efficiently
  • Build relationships in the region and identify best partners (e.g., other specialists, home health agencies, hospitals) for Upperline to send referrals when needed
  • Develop clinical compliance guidelines and protocols

Required Experience and Qualifications
  • Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.)
  • Board certified in Internal Medicine, Family Medicine, Preventative Medicine, or Geriatrics
  • Active license in South Carolina and willing to pursue multi-state licensure if needed
  • Fellowship training in Geriatrics and/or other advanced degrees (e.g., M.B.A., M.P.H., M.H.A.) valued but not required
  • ~ 5 years of outpatient practice experience
  • Clinical leadership experience in a VBC or Population Health company
  • Experience with managed care and familiarity with payer-provider collaboration
  • Owned or been part of creating, improving, and/or implementing clinical processes, protocols, or evidence-based guidelines
  • Experience or exposure to rolling out and/ or managing VBC programs (e.g. Transitional Care Management, Complex Care Management, ED Diversion, Advanced Care Planning, High Risk Patient Outreach)
  • Talent for synthesizing information and solving complex problems; can independently translate high-level goals into actionable plans
  • Proven leadership skills and servant leadership mentality with a passion for people and culture
  • Ability to communicate, collaborate and work effectively with staff, providers, and organizational leaders
  • Self-starter with a bias for action orientation; demonstrates a service excellence mindset
  • Exceptional organizational and project management skills and the ability to prioritize and multi-task autonomously
  • Comfortable working in Excel; able to analyze data and present findings
  • Must be willing and able to routinely visit clinics and providers within the region; Residing in the market or region is strongly preferred

BENEFITS

Comprehensive benefit options include medical, dental and vision, 401K, PTO, and parental leave.

COMPENSATION

Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience.

Job Type: Full-time

Similar Jobs

More Jobs at Upperline Health

More Healthcare Jobs

Find similar Medical Director, Value Based Care jobs: