Medical Director, Clinical Transformation - Medical Specialist

GENERAL SUMMARY:

The Medical Director for Clinical Transformation- Medical Specialist is a physician who sees mostly adult patients in their clinical practice. This physician serves as a key clinical leader within the Mosaic Clinically Integrated Network (CIN), responsible for guiding strategic initiatives that enhance provider performance, quality of care, and operational efficiency. The physician in this role is expected to provide Medical Director Services for approximately 8-16 hours per week. This position is responsible for supporting the development and execution of strategies that promote high-value care, enhance patient outcomes, and ensure alignment with the CIN's goals, including the Quintuple Aim. Administratively reporting to the Chief Medical Officer of the CIN, the Medical Director collaborates closely with network leadership, physicians, and care teams to support clinical excellence, implement quality improvement strategies, and promote a culture of continuous improvement across the CIN.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

1. With direction from the Network Chief Medical Officer and the Clinical Performance Committee, provides clinical leadership in support of the development, implementation, monitoring and ongoing improvement of the network's Clinical Integration program including but not limited to metrics, registries and scorecards.

2. Provides clinical leadership to care transformation (redesign) efforts, partnering with Director(s) of Clinical Transformation.

3. Provides clinical leadership for the Provider Performance Management process/policy, including working proactively with providers on performance issues as well as contacting, counseling, mentoring and improving results for physicians in Focus Review Plans. Makes recommendations to clinical performance committee, credentialing committee, and/or board of managers on actions.

4. Provides clinical leadership for credentialing function to help ensure timely onboarding of appropriately trained and credentialing providers.

5. Provides clinical leadership to cost of care analyses, overall, by specialty, by practice, by physician. Identify outliers and best practice methods, work with physicians to move needle on efficiency while maintaining/improving quality outcomes.

6. Provides clinical leadership to identification and establishment of metrics that monitor our performance on achieving quintuple aim objectives, including assisting with identification of annual Clinical Integration Program incentive metrics.

7. Provides clinical leadership to patient complaint policy/protocols including investigation, review, resolution and reports as needed.

8. Provides clinical leadership to support CIN staff working in physician offices as needed.

9. Governance and other meeting attendance with help supporting when needed, including Clinical Performance Committee (monthly), Credentialing Committee (monthly), Provider Quality Champion (quarterly), Specialty Advisory Council (monthly).

10. Provides clinical leadership to support grant opportunities as needed.

11. Provides detailed written documentation the work performed in a manner that is compliant with Employer's policies and procedures.

EVALUATION PROCESS:

At least annually, the Medical Director shall meet with the CIN President and/or his/her designee to review the operation of the program and the parties' respective performance under this Medical Director position description. The focus of this process shall be upon constructive review, continuous quality improvement, and the avoidance of recurrent deficiencies in services. Without limitation of prerogatives of either of the Parties stated elsewhere, the intent of the parties in this process shall be to mutually find the best means to improve quality and efficiency rather than to assert respective rights, blame, or purely technical deficiencies.