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Ochsner Health Medical Director - Risk Optimization

Company: Ochsner Health
Location: New Orleans
Posted on: January 27, 2023

Job Description:

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 adjustment programs.
  • 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 preferred.
    • 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 others.
      • 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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