Primary accountability for quality and cost of medical care provided to inmates throughout the assigned region. Collaborates with the Vice President of Operations (VPO) to develop long lasting client partnerships by delivering quality cost effective care.
CONTRACT INFO: Corizon provides services to 17 sites throughout the state of Virginia, including primary care, dental and psychiatry. The contract was awarded to Corizon in March and will begin May 1. There are approximately 425 FTEs in the state, including 18.12 site medical directors and staff physicians that this Regional Medical Director would oversee.
Performance Improvement (30%)
Sets and maintains clinical standards in the region by driving decisions that are patient–centered, collaborative, evidence based, and focused on both quality and utilization.
Provides clinical leadership for statewide care management: monitors site results through data review and care management calls which decrease negative variances and promotes the sharing of best practices.
Conducts medical leadership meetings to educate team and oversee clinical quality processes. at least quarterly.
Oversees quality of care delivered by offsite and onsite specialists within the region.
Interprets trends and takes action at the regional level for improving health status of the population, partnering with the client to implement appropriate interventions.
Develops and leads a team of physicians in UM decision making, compliance with clinical quality and UM programs specific to contract requirements, and adherence to corporate UM and clinical quality policies and procedures.
Takes action on Doctor sick call grievance trends and implements region wide process improvement.
Identifies opportunities for enhancements and works with regional team to design and implement changes to improve efficiency in clinical operations and workflow.
Mentors, monitors, and utilizes regional staff in the appropriate use of medications (formulary, and non formulary) and in medication administration (e.g. side effect profile, adherence, drug/drug interactions).
Client Satisfaction (30%)
10. Builds and maintains productive relationship with client leaders (including client CMO when applicable) through regular communication and face to face meetings, including one on one meetings.
11. Collaborates with the contract administration team in the preparation, review and presentation of the annual client report.
12. Actively participates in Clients for Life client activities.
13. Proactively informs client of risks and high profile patient management cases and how both are being managed.
14. Partners with VPO to regularly update the client as to results, improvements needed, and how we are meeting/exceeding client expectations.
People & Talent Management (30%)
15. Collaborates with VPO, Regional Director (RD) and other site operational leaders to identify, interview, select, and retain Site Medical Directors and site physicians. Knows and ensures compliance with credentialing requirements for all providers, independent contractors and physician assistants across area of responsibility.
16. Confirms Physician Information Programs (PIPs) are completed timely and accurately for all new providers either personally and/or with Associate Regional Medical Director (ARMD).
17. On-boards, supervises and mentors Site Medical Directors and ARMDs in UM and QI tools, techniques and processes within the corrections environment.
18. Role models and develops strong leadership and management skills in Site Medical Directors and ARMDs.
19. Mentors Regional Director of Nursing (RDON) by sharing clinical and administrative objectives and collaborating on planning for and taking action to achieve stated goals.
20. Mentors PLP (Physician Leadership Program) participants for the purpose of preparing them for the next level of responsibility.
21. Confers with regional team daily to stay apprised of critical situations, collaborate on action steps and/or treatment plan, paying attention to trends and opportunities for improvement.
22. Conducts thorough and timely Peer Reviews for Medical Directors and non-physician practitioners, according to Corizon policy and procedures.
23. Identifies candidates with leadership potential from among site physicians/site medical directors, creates development plans and mentors these high potentials.
24. Represents Corizon and correctional medicine at medical and osteopathic residency programs, conferences, and other venues in order to create awareness about correctional medicine and CMS.
25. Creates team environment and maximizes team effectiveness by collaborating with physician staff, non-physician practitioners and nursing personnel.
26. Builds and maintains strong relationships with site medical providers by visiting all sites they are responsible for, in person.
Financial Management (10%)
27. Improves regional results by analyzing data, developing strategies, and establishing enhanced expectations for Site Medical Directors.
28. Defines and analyzes monthly utilization and cost trends for the area using corporate data.
29. Works with the regional team to develop and manage the regional budget—in particular the provider staffing needs and UM and pharmacy targets.
American Hospital Association - 17 months ago
Prison inmates can't really shop around for health plans, but depending on where they are held, they may have access to Correctional...