Job Description

The Executive Medical Director (EMD), In-Home Primary Care (IHPC) Clinical Operations will report to the Home-Based Care Chief Medical Officer and will work as a dyad partner with the IHPC Operations Director. The EMD Clinical Operations will be responsible for overseeing, managing and optimizing In-Home Primary Care clinical operations while ensuring patients receive high quality, evidence-based care. The EMD, Clinical Operations will partner closely with operational management and the Shared Services team to achieve required key performance indicators (KPIs) and service level agreements (SLAs) to ensure critical clinical, operational, and financial needs of the business are being met. They will collaborate with other clinical leaders to create/refine onboarding programs as well as monthly clinical team training. To remain compliant with federal and state regulations, the EMD, Clinical Operations will conduct auditing activities in coordination with the Compliance and Coding teams to ensure program integrity.Essential Job Functions include, but are not limited to:Manage In-Home Primary Care physicians and Nurse PractitionersWork in collaboration with the IHPC Operations Director to direct care delivery interventions to achieve the clinical outcomes of the In Home Care programEnsure clinical care is consistent with current Home-Based Care standardsRoutinely review key quality metrics and provide routine updates to senior leaders (monthly, quarterly, etc) in partnership with the Operations DirectorCollaborate with Operations Director to monitor reports and dashboards to problem solve deficits as identified in clinical metrics, patient satisfaction, consent reports, HEDIS, gaps in care, and complaint tracker.Serve as a source of clinical consultation for the provider teamCollaborate to develop and deliver clinical education to help clinical teams attain program outcomes.Lead clinical, ad hoc and standing meetings as neededMentor and develop clinical leaders to achieve program outcomes.Perform regular chart review for provider team members based on individual performance needsProvide oversight of clinical care delivered during normal business and after hours to ensure interventions are aimed at improving quality of life and management of chronic illnesses while reducing unnecessary utilization of healthcare resourcesReview Emergency Department visits, hospital admissions and readmissions to assess trends and develop action plans and guide clinical decision making for interventions to appropriately reduce ADK/EDKReview and provide clinical guidance about admission/discharge from programCommunicate with external stakeholders to facilitate collaboration and improve clinical outcomesParticipate in client JOCsCollaborate with Operations Director to address complaints/grievances/concerns when of a clinical natureOversee training efforts of EMR enhancementsNew HiresResponsible for hiring forecasting to ensure appropriate staffing for current and new marketsInterview potential new hires and collaborate with shared services and operations teams to onboard new providersCoordinate mentoring/training of new hires with market clinical leads, ensuring frequent (daily/weekly) touchpoints during first three months of hireParticipate as active member on Quality Review Committee and Peer Review CommitteeBuild strong working relationships with internal department managers and external partners.Minimum QualificationsBoard-certified physician in Internal Medicine or Family Medicine and with a current unrestricted medical license.Minimum of 5+ years of experience in clinical practice & leadershipMust have current BLS certificationMust have active/unrestricted license in state of residenceDEA license and State Controlled Substance License upon hire or within 6 months of hireMust be able to be credentialed by Medicare, Medicaid, and other Private Insurance CompaniesDemonstrated excellence as a clinician, attaining HBC program goals, and ability to lead others in this work.Dedication to transforming care for the sickest and frailest in a marginalized population and directing others in this endeavorEagerness to work and lead a diverse and multidisciplinary teamComfortable with providing care in a home settingExhibits ethical and professional behavior.Previous experience working with and mentoring providers in a team approachSuccess in carrying out and maintaining cooperative, successful relations with diverse internal and external stakeholders.National travel required as needed - approximately 25%Preferred QualificationsGeriatric fellowship or palliative training desired * At least 5 years of industry-related leadership experienceComputer Competency: Microsoft Office - Word, PowerPoint, Excel competency, Epic experience, on-line medical research.Ability to analyze performance metrics and create solutions to improve outcomesAbility to be agile with change managementLocation: Remote, Work from home anywhere in the U.S.If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 219,900 - 366,500 USD / yearly, depending on relevant factors, including experience and geographic location.This role is also anticipated to be eligible to participate in an annual bonus and long term incentive plan.We want you to be healthy, balanced, and feel secure. That\xe2\x80\x99s why you\xe2\x80\x99ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you\xe2\x80\x99ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit .About Evernorth Health ServicesEvernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.Cigna has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

The Cigna Group