Primary Care Physician Lead at CenterWell Senior Primary Care summary:
The Primary Care Physician Lead manages a team of clinicians to deliver high-quality, value-based care focused on seniors' physical, emotional, and social wellness across multiple centers. This role combines direct patient care with administrative oversight, including clinical strategy implementation, staff management, quality improvement, and collaboration with operational leadership. The position also involves community representation, participation in committees, and initiatives to optimize healthcare delivery and costs within a Medicare Advantage framework.
Become a part of our caring community and help us put health first
Humana’s Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country, operating over 340 centers across fifteen states under two brands: CenterWell & Conviva. Operating as a payor-agnostic, wholly owned subsidiary of Humana, our centers put the unique needs of seniors at the center of everything we do. Our Clinics offer a team-based care model where our physicians lead a multi-disciplinary care team supporting patient’s physical, emotional, and social wellness.
At CenterWell Senior Primary Care we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all.
The Physician Lead serves as a health-care professional and capable of handling a variety of health-related problems. The Physician Lead works on problems of diverse scope and complexity ranging from moderate to substantial.
The Physician Lead (PL) serves as a leader to a team of clinicians in a designated market responsible for handling a variety of health-related problems and educating patients and their families on wellness, prevention, and early detection. The PL is responsible for executing the clinical strategy through the management of their own patient panel as well as those of the clinicians whom they lead.
The PL reports directly to the Market CMO and is directly responsible for
- Administrative oversight and outcomes determined by the Clinical / Operational Leadership of the Market
- Spend a portion of time clinically-focused on direct patient care, with the remaining time dedicated to administrative duties related to oversight of clinical provision of care including, but not limited to:
Working collaboratively with Market CMO and Operational Leadership to:
- Advance the Model of Care
- Create profit improvement initiatives
- Design operational implementations
- Contribute to the strategic intent
Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in:
- Maintaining Collaborative / Supervisory Agreements per state protocols
- Assisting with panel management
- Providing direct education to clinicians around clinical protocols / disease
- prevalence / appropriate levels of clinical quality care
- Providing guidance to individual clinicians about patient terminations, in
- collaboration with Compliance
- Supporting clinicians with schedule templates, coverage, daily issues
- Managing behavioral concerns of supervised staff
- Assisting with PTO Management
- Assisting with CME time and reimbursement requests
- Assisting with completion of performance reviews
- Assisting in resolution of inquiries, requests, and complaints from clinical staff
- Assisting in organizing team building activities
- Assisting in resolution of inquiries, requests, and complaints from patients
- Ongoing chart review / audit of clinical staff to ensure quality care and identifying opportunities for education/coaching
- Identifying trends and areas of opportunity in pharmacy utilization (pharmacy management) to impact Part D per Member per Month (PMPM) costs while maintaining high quality care
- Optimizing network; preferred network specialists – contributing to the identification of preferred network specialists to optimized delivery of care for ongoing maintenance / cost saving opportunities
Making decisions related to the identification and mitigation of complex technical and operational problems within clinics/centers
- Managing financial / operational performance of their assigned clinics to ensure success
- Participating in provider committees (i.e. Technology Governance, EMR Optimization, etc.) and attending meetings regularly
- Participating in Shared Service Strategy Meetings
- Participating in quality improvement programs, population health programs, continuing education, and other patient care programs established by clinical requirements
- Assisting in recruiting and interviewing of potential clinical staff
- Participating in patient retention and marketing activities as required
- Serving as a community representative in the media and press activities
Other duties as directed by the Market CMO
- Maintaining confidentiality of all patient information according to both state and federal
guidelines and regulations - Maintaining medical history and medical records
- Ordering studies, tests and ancillary services
- Participating as a back-up on-call physician
- Prescribing medical treatment and clinical drugs to patients
- Referring patients to specialists as needed
Use your skills to make an impact
Required Qualifications
- MD/DO
- 8 or more years of technical experience
- 2 or more years of project leadership experience
- Licensure requirements of the state of jurisdiction
- Graduate of accredited MD or DO program of accredited university
- Prefer Internal Medicine specialty
- Board Certification in Family Medicine, Internal Medicine or Geriatric Medicine
- This role is considered patient facing and is part of Humana/Senior Bridge's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
- Active and unrestricted DEA license
- Medicare Provider Number
- Medicaid Provider Number
- Minimum of three to five years directly applicable experience preferred
- Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value based relationship environment.
- Knowledge of Medicare guidelines and coverage.
- Knowledge of HEDIS quality indicators
- Good understanding of best practice coding and documentation in value based environment
- Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results.
- Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
- Accountable: You meet clearly stated expectations and take responsibility for achieving results.
- Clinical Knowledge: You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs
- Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.
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Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$223,800 - $313,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Keywords:
primary care physician, clinical leadership, value-based care, senior health, Medicare Advantage, team-based care, patient management, chronic disease management, clinical strategy, healthcare administration
