Nephrology Medical Director OH

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AbsoluteCare is seeking a dynamic physician leader to put the principles of population health into action for our medically complex & socially vulnerable members with kidney disease. Oftentimes, due to the effects of trauma and poverty, a significant portion of our population suffer from kidney disease. Through our integrated care teams, including physicians, advanced practice practitioners, nurse care managers, social workers, behavioral health therapists, peer counselors, dietitians, pharmacists, and community outreach workers, we transform the lives of our members.
Working within our matrix organization, the Nephrology Medical Director will collaborate closely with the Medical Directors and National Directors of their respective disciplines to provide clinical leadership and expertise in the development and implementation of care strategies for nephrology patients. As a dyad partner with the Practice Administrator, the Nephrology Medical Director will be responsible for all the Nephrology patients outcomes. Utilize data analytics and performance metrics to track patient outcomes, identify areas for improvement, and drive quality initiatives. This role is instrumental to our fast-growing organizations success, and requires a person who exhibits dynamism, humility, clinical acumen, the ability to work collaboratively, and strong leadership skills.
Job Summary:
The Nephrology Medical Director serves as clinical leader providing expert guidance and oversight to ensure the delivery of high-quality, evidence-based nephrology care affordability, decreased total cost of care within the framework of value-based principles. This role encompasses leading a transitional care team, establishing relationships and communication pathways collaborate with nephrologists, primary care physicians, hospital systems, payers, and other stakeholders to ensure coordinated and high-quality care delivery. Oversight of clinical, utilization management, and financial total cost of care outcomes for total members attributed to AbsoluteCare; whether member chooses AbsoluteCare or not.
Facilitating and leading discussions with AbsoluteCare and Non-AbsoluteCare providers regarding appropriate care, utilization, and care coordination. This includes inpatient, emergency department, skilled nursing facilities, specialists, primary care providers, home nursing and other providers within the healthcare ecosystem.
Key Responsibilities:
Provide clinical leadership and expertise in the development and implementation of value-based care strategies for nephrology patients. Collaborate with nephrologists, primary care physicians, hospital systems, payers, and other stakeholders to ensure coordinated and high-quality care delivery. Develop and implement clinical pathways, protocols, and best practices that align with value-based care principles and evidence-based medicine. Ensure compliance with all relevant clinical, legal, and regulatory requirements related to value-based care and nephrology practice. Participate in the development and management of risk-sharing arrangements and other value-based payment models. Sub-Specialty Network Development: Spearhead the cultivation of a sub-specialty network that supports in integrated, high value specialized care for patients including home health. Quality Metrics and Patient Safety: Focus on achieving superior performance in HEDIS quality metrics, clinical coding documentation excellence, patient safety, engagement, and satisfaction. Strategic Initiatives: Implement strategic medical operations and protocols aimed at achieving the organization's value-based clinical and financial total cost of care goals. Team Leadership: Provide guidance and leadership to medical staff, fostering a collaborative environment that encourages innovation and continuous improvement.
Minimum Qualifications:
Medical degree (MD or DO) with board certification in Nephrology. Active medical license in the relevant state. BLS certification required. Significant clinical experience in nephrology, with a strong understanding of chronic kidney disease and end-stage renal disease management. Demonstrated experience and knowledge of value-based care models, principles, and practices. Experience with data analysis and performance management in a healthcare setting. Strong leadership, communication, and interpersonal skills, with the ability to collaborate effectively with diverse teams. Understanding of healthcare regulations and compliance requirements. Experience with Milliman Care Guidelines or health plan operations (Medicaid, Dual, and/or Medicare Advantage a plus) Knowledge and experience - population health management with vulnerable, complex Medicaid, Dual, and/or Medicare Advantage populations Excellent clinical skills with a strong focus on quality metrics and population health management.
Working Conditions: This role operates in both a clinical and administrative environment. There may be potential exposure to blood, bodily fluids, and infectious materials. Use of standard office equipment and occasional travel between facilities is required.
Physical Requirements: Must be able to communicate effectively and remain stationary or move about for prolonged periods.
Approval and Review: This job description is subject to change and may be reviewed and revised by management at any time.
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Location:
Cincinnati, OH, United States

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