Medical Director – Clinical Effectiveness

John Muir Health, Walnut Creek, California
July 28, 2016

Job Overview

The medical director is a physician executive who is responsible for quality, credentialing, and error prevention for the Medical Group and Medical Group IPA physicians.

 

GENERAL DESCRIPTION OF DUTIES:

The Medical Director provides clinical direction for quality and safety related programs, utilization review, and clinical guideline development as well as implementation where necessary. The Director oversees and aligns the credentialing process for the John Muir Physician Network (JMPN) to be consistent with other John Muir Health settings where appropriate. S/he works closely with Network senior management, leadership of medical groups and IPA leadership to ensure alignment. This individual represents JMH in the community, maintaining relationships with JMH partners and health plans where appropriate as well as advises and participates in the development of a Clinically Integrated Network for John Muir. Specific focus on HMO products and DMHC as well as NCQA requirements is critical. Reports to: Chief Medical Officer.

 

Population Health

  • Support population health activities, including public outreach, identifying and addressing gaps in care, palliative care, and pain management

 

Quality Improvement/Safety

  • Monitor quality and appropriateness of medical care, including adherence to clinical guidelines, safety, hospital use (utilization patterns, appropriate admissions, appropriate readmission rates), access, and patient experience
  • Provides oversight for development of clinical guidelines/protocols associated with Clinically Integrated Network in addition to JMPN HMO network
  • Acts as liaison between quality/safety and contracting, assuring consistent metrics aligned with JMH Quality Framework/measure crosswalk are aligned with health plan contracts
  • Provides consultation to contracting department related to clinical quality metrics, definitions, and population health goals
  • Develop strategies and in conjunction and where appropriate as illustrated by our Delegated responsibility to HMO Health plans works with JMPN leadership and IPA leadership to improve patients’ access to care both primary and specialty
  • Collaborate with Quality to identify variations in practice patterns, communicate and participate in teams related to reducing variation
  • Champion policies, procedures, and practices related to error prevention and high reliability
  • Responsible for network peer review; and serves as a liaison to the JMH peer review process; counsels physicians and resolves identified behavioral and impairment issues
  • Accountable for physician compliance with publicly reported quality, including IHA, Star, PQRS, and Meaningful Use (MU)

 

Minimum Requirements

  • M.D. or D.O. degree from an accredited medical school
  • Master degree in administration, business, public health related graduate degree preferred
  • Licensed to practice in California Board, certified in area of practice (currently or previously)
  • Three to five years of experience as a change agent, including demonstrated improvement in clinical outcomes, patient experience, and safety
  • Two to three years of experience in quality management and performance improvement
  • Experience with electronic health records, EPIC preferred
  • Knowledge of local, state, and national regulations and standards
  • Knowledge of health plan clinical quality programs
  • Prior experience in a leadership role
  • Strong interpersonal and communication skills
  • Strong organizational skills with a demonstrated ability to manage multiple tasks, activities and priorities
  • Comprehensive working knowledge of quality improvement data, including statistical data
  • Computer literacy and working knowledge of Microsoft Windows including Word, Excel, Access, and Outlook

 

Interested individuals should email resume to Amy Anderson, Human Resources Dept., at amy.anderson@johnmuirhealth.com

John Muir Health is a nationally recognized, not-for-profit health care organization. It includes John Muir Medical Center, Walnut Creek (554-bed acute care facility) , which serves as Contra Costa County's only designated trauma center and John Muir Medical Center, Concord (245-bed acute care facility).Together, they are recognized as top centers for neurosciences, orthopedics, cancer care, cardiovascular care and high-risk obstetrics. Other areas of specialty include general surgery, robotic surgery, weight-loss surgery, rehabilitation and critical care. John Muir Health also offers complete inpatient and outpatient behavioral health programs and services at our Behavioral Health Center (73-bed fully accredited psychiatric hospital) located in Concord. In addition, John Muir Health provides a number of primary care and outpatient services throughout the community and urgent care centers in Brentwood, Concord, San Ramon and Walnut Creek.

John Muir Health is a collaborative, patient-centered health care environment; listening, explaining and working together as a team, to help patients achieve their optimal health. We recognize those who exemplify excellence, and reward them for contributing to our collective success. From individual to department to spontaneous recognition, Employee Suggestion Program rewards, Employee Success Sharing Program, and many more, we find unique ways to thank our employees for the outstanding efforts they make every day. Competitive salary and benefit package available.

All hospitals are accredited by The Joint Commission, a national surveyor of quality patient care. John Muir Health is an equal opportunity employer.