Ochsner Health Medical Director - Risk Optimization
Company: Ochsner Health
Location: New Orleans
Posted on: January 27, 2023
The Ochsner Health Medical Director - Risk Optimization reports
to the Chief Population Health Officer with dotted line reporting
to the AVP, Risk Optimization. This 0.8 FTE position provides
clinical leadership for all aspects of risk adjustment pertinent to
Ochsner Health and Ochsner Health Network's Medicare Advantage,
Medicare Share Saving Program, and Commercial value-based
agreements. The medical director will have shared accountability
for the clinical aspects of HCC training and education, provider
feedback, and program effectiveness. The medical director is
responsible for working collaboratively with other population
health solutions that align with the broader value-based
performance management strategy. Key Outcomes:
- Supports all clinical aspects of risk adjustment, including,
but not limited to: provider education and feedback, coding and
clinical documentation, eAWV planning and completion, provider
incentive programs, and outcome measurement.
- Supports the AVP, Risk Adjustment, as physician leader in all
clinical aspects of risk adjustment focused programs and services.
Will include presentations at operating reviews, and to payors,
providers, and regional leadership teams as needed.
- As medical director for risk adjustment, develops effective
EPIC strategies and tools, including EPIC HCC BPA for primary care
and specialties, evaluation and enhancement of Ochsner developed
tools, which include Black Dot/Green Dot, InBox messaging, and
chronic disease capture.
- Develops strategy and implementation plan to bring natural
language processing (NLP) functionality into our HCC risk
- Works in conjunction with the Ochsner government relations
staff to develop strategies that support risk adjustment outcomes
at the federal policy level.
- Providers clinical oversight to nurse practitioner lead eAWV
activities, including in office, telehealth and/or telephonic, or
home based. Qualifications Education/Experience:
- Medical degree with 5+ years of practice experience, Board
certified in current specialty.
- Active and unrestricted license to practice medicine or surgery
in Louisiana required.
- 3-5+ years of applicable medical director experience, will
demonstrated knowledge of health care systems, including medicare
advantage and medicare shared savings programs.
- Advanced degree (MBA, MMM), or progress towards such degree is
- Specific knowledge of HCC risk models, clinical documentation
and coding expertise. Skills/Knowledge/Competencies:
- Knowledge and practical understanding of healthcare systems and
HCC risk adjustment methodologies and programs.
- Demonstrated ability to lead change (internally and externally)
and produce measurable results within a specified time period.
- Demonstrated ability to lead, manage and collaborate with
- Good analytic skills with the ability to identify meaningful
trends and targets for improvement.
- Excellent interpersonal skills and the demonstrated ability to
establish rapport and working relationships with providers, payors,
and internal staff.
- Strong communication and presentation skills; ability to tailor
message to a variety of audiences.
- Successful utilization of process improvement tools and methods
to achieve results Interested physicians should apply HERE Ochsner
Health is a system that delivers health to the people of Louisiana,
Mississippi and the Gulf South with a mission to Serve, Heal, Lead,
Educate and Innovate. Ochsner Health is a not-for-profit committed
to giving back to the communities it serves through preventative
screenings, health and wellness resources and partnerships with
innovative organizations that share our vision. Ochsner Health
healed more than 876,000 people from across the globe in 2019,
providing the latest medical breakthroughs and therapies, including
digital medicine for chronic conditions and telehealth specialty
services. Ochsner Health is a national leader, named the top
hospital in Louisiana and a top children's hospital by U.S. News &
World Report. As Louisiana's leading healthcare educator, Ochsner
Health and its partners educate thousands of healthcare
professionals annually. Ochsner Health is innovating healthcare by
investing in new technologies and research to make world-class care
more accessible, affordable, convenient and effective. Ochsner's
team of more than 26,000 employees and 4,500 providers are working
to reinvent the future of health and wellness in the region. To
learn more about Ochsner Health, please visit . To transform your
health, please visit . Ochsner is an equal opportunity employer and
all qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, national origin,
sexual orientation, disability status, protected veteran status, or
any other characteristic protected by law.
Keywords: Ochsner Health, New Orleans , Ochsner Health Medical Director - Risk Optimization, Executive , New Orleans, Louisiana
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