Gould Medical Group, in partnership with Sutter Health, is seeking a Medical Director for Accountable care in Modesto, California.
Sutter Health-affiliated Gould Medical Group is a growing, approximately 400 provider multi-specialty group located about two hours east of San Francisco, California. Our communities offer quick access to the bay area as well as other hot spots such as Napa Valley, Yosemite, and Lake Tahoe.
The GMG Accountable Care Medical Director (ACMD) is responsible for the creation, guidance, and implementation of new models of clinical care that will promote quality and affordability in a “Value-Based Care” model that meets employers’, payers’, and individual patients’ demands for high value, integrated, affordable care. This position has operational oversight of the Managed Care, Utilization Management, and Variation Reduction functions for GMG and SGMF. This position will partner with key executives in GMG and SGMF, Greater Central Valley Market and Sutter Health Network to accomplish these objectives. To achieve this objective, the ACMD must build strong relationships with Sutter-affiliated and non-affiliated hospitals used by SGMF aligned physicians and with clinical leaders throughout Sutter in support of population health objectives. In summary, the ACMD will lead the clinical transformation of SGMF from a fee-for-service company to a population management company, working in alignment with Sutter Health clinical integration initiatives.
This position reports to the GMG Chief Medical Officer who works in tandem with the Central Valley Market CMO and Sutter Health Network leadership for strategic alignment of priorities. This position is responsible to report on activities to the Group and Foundation leadership. Performance evaluations to be completed by GMG Chief Medical Officer.
III. Principal Accountabilities:
Guides the creation and implementation of new clinical care delivery models at SGMF focused on the provision of superb clinical care in a “Value-Based Care / Population Management” environment. These responsibilities include (but are not limited to):
Leads/manages the development of a strategy and implementation approach for the creation and oversight of critical clinical and administrative functions necessary to support the migration to a Value-Based Purchasing reimbursement environment.
Identifies opportunities for continuous TCOC improvement and supports operational change.
Works collaboratively to identify and promote the creation of care models to most effectively manage the “sickest” 10% of our patient populations.
Monitors appropriate metrics for success in a value-based operating environment.
Visions and messages with leadership, staff, and physicians the importance of moving our business towards value-based models and solutions for success in the TCOC environment.
Acts as a member of the Leadership Team as a practitioner and coach for the Gould Practice System (GPS) lean journey.
Provides oversight for UM / Managed Care functions.
Leads a data-driven approach to success in a TCOC operating environment. Guide the conversion of data to knowledge.
Supervises the GMG Medical Directors of Utilization Management.
Works collaboratively with like physician leaders and network performance management functions within Sutter to design and implement different care models to efficiently enhance population health.
Provides oversight of Ambulatory Care Coordination functions.
Partners with local SPHS leadership and acts as Medical Director for the SPHS Value-Based Care Management team responsible for GMG patients.
Supports the effective integration of care coordination activities in SGMF care centers to promote team-based care and patient engagement.
Acts as a liaison between GMG and Sutter hospital based SPHS leaders as it pertains to care coordination for SGMF patients.
Provides oversight of the Variation Reduction and Clinical Pathways programs.
Drives changes to clinical care delivery through a participatory process that engages physicians and other stakeholders in the exchange of quality, efficiency and other data so as to determine optimal, consistent clinical approaches to care.
Supports the Clinical Section Chiefs and Chairs with Variation Reduction and Care Pathway implementation.
Ensures that Variation Reduction and Care Pathway activities are coordinated and supportive of other Service Line activities.
Participates as a key member of Market activities related to Value-Based programs.
Participate as an integral member of the leadership team interfacing with self-insured employers and health plan partners.
Be a resource for Market Contracting, Strategy, Finance, entity CEOs and others regarding value-based programs.
Work in partnership to assist leadership at non-Sutter hospitals in our geography to implement necessary TCOC management programs.
Provide strategic context and direction for the continued development of the Sutter Health Network.
Ensures that effective relationships are built and maintained with physician leadership, market leadership and system counterparts to ensure high levels of quality and service are enhanced in a value-based care environment.
Actively participates in and leads interdisciplinary and multidisciplinary teams in support of value-based care initiatives at GMG and SGMF
Acts as a leader and active participant in GMG Clinical Leadership Team and Paired Leaders meetings.
Reports on medical group value-based performance status per request or need.
Operates effectively within GMG, SGMF, Regional partners and Sutter Health.
Keeps the GMG President, GMG CMO, Market CMO, and SHN Leadership advised on current activities that affect or have potential impact on the entity, area or system.
Actively participates in and leads committees or teams relevant to UM, care coordination, and quality in support of value-based performance improvement.
Meets regularly with local CEOs, physician leadership and other stakeholders to ensure coordination on top priorities and initiatives related to value-based care.
Chairs and/or actively participates in meetings designed to assure effective planning, business development and marketing efforts between key internal staff.
Participates as a member of the SGMF/GMG Management Team in charting the future of our organizations and assuring continuous improvement in overall effectiveness, efficiency and integration and alignment with the System.
Brings knowledge of functional needs and issues to the discussions and decision-making process.
Assures effective communications between function and operations.
Practices Lean leadership through the practice of Leader Standard Work, coaching and mentoring GPS principles and practices and embodying servant leadership.
V. Freedom to Act/Accountability:
The incumbent has the authority to interview, hire, train, evaluate, counsel, discipline, recommend salary increases, set work schedules and assign and review work within the areas of responsibility.
VI. Working Relationships/Contacts:
The incumbent has substantial working relationships and contacts with SGMF, GMG, Memorial Medical Center of Modesto, Sutter Tracy Community Hospital, Los Banos Hospital, the Greater Central Valley Market and Sutter Health, including physician leadership, executives, and managers. The incumbent works closely with SGMF Operations, Market Presidents and CMO, Division Finance, Strategy and Managed Care Contracting, SH Clinical Integration, SHN, Strategy, Marketing and Communications staff. This position also has frequent contact outside the organization with vendors, consultants, and professional peers.
VII. Quantifiable Dimensions:
Total Medical Group Providers
Unique Patient Lives
VIII. Position Requirements:
Education: This positionrequires a medical degree (MD or DO) and an active and unrestricted license to practice medicine at GMG. Masters level preparation (MBA, MHA, MPH, MPP) is preferred.
Knowledge: Thorough knowledge of managed care, physician group operations and patient care financing within an integrated system-based delivery organization are required. Knowledge of economic risk is preferred.
Experience: Extensive, proven, successful experience demonstrating positive results in an operations role, experience with utilization management and transitions of care required. Experience in a multi-specialty group practice and in a matrix management environment highly desirable.
Skills: Demonstrated skill in establishing and maintaining effective working relationships with physicians, operational leaders, and key customers. Must have excellent written, verbal, presentation and interpersonal skills. Must have excellent problem identification, analysis and resolution skills. Must have the ability to create an environment that encourages cooperation, motivation, innovation, and high-performance teamwork. Ability to delegate responsibility and authority to staff. Ability to delegate responsibility and authority to staff. Must be able to communicate complex strategic and business development information to physicians and “lay” stakeholders. Database / analytic skills desired. Expertise in Lean preferred.
Physical Effort: Tight deadlines, changing priorities, early morning, evening and weekend hours, and travel. May lift or carry equipment up to 20 lbs. occasionally.
Starting base salary for .5 FTE Medical Director component: $175,000 annually and $37,500 bonus potential. Additional .5 FTE clinical work will be paid based on clinical specialty.
Sutter Health-Affiliated Gould Medical Group is a physician-owned, 400 provider, multi-specialty group located in the heart of California’s Central Valley. Gould Medical Group has been providing services in the Central Valley of California for over 70 years. Affiliation with Sutter Gould Medical Foundation, Sutter Health, and area hospitals gives Gould Medical Group physicians access to modern facilities, advanced technology, and ease of practice in a doctor-friendly atmosphere.