Medical Director, Value Based Care

ABOUT US

Upperline Health is transforming healthcare by providing comprehensive patient care through frequent specialist visits. As the nation’s largest specialty Accountable Care Organization (ACO), we are revolutionizing the way value-based care is delivered—breaking down silos between specialists, primary care providers, payors, and patients to ensure a holistic, coordinated approach to health. Since our founding in 2017, we have expanded to serve over 500,000 patients across 19 + states, delivering expert care in chronic condition management, podiatry, vascular, endocrinology, wound care, primary care and more. At Upperline Health, we recognize that the path to wellness is not always simple, but we are dedicated to making it accessible and effective for every patient we serve.

We believe:

Triage is temporary. 

Treatment is transformative.

Upperline Health providers coordinate patients’ care among a team of specialists – physicians, advanced practice providers, care navigators, pharmacists, dieticians, and social workers for integrated treatment that addresses patients’ immediate and long-term health needs.

Through a patient-centered approach, we enhance the healthcare experience by living our Upperline CARES values—fostering strong Connections, holding ourselves to the highest level of Accountability, demonstrating Resilience in navigating and tackling complex challenges, committing to Excellence in patient care, and focusing on a Service mentality that places patients at the heart of everything we do.

 

ABOUT THE MEDICAL DIRECTOR, VALUE BASED CARE

Upperline is seeking a Medical Director, Value Based Care (VBC) to join the clinical leadership team in developing, implementing, and growing our unique value-based care model in Kentucky. The VBC Medical Director will serve as a clinical leader partnering with Operations and Population Health leaders to deliver successful value-based care results across the market.

As the VBC expert and clinical leader, this individual will be focused on improving outcomes and quality of life for our most high-risk patients while lowering the total cost of care. Key aspects include leading population health initiatives as well as clinical supervision, coaching and working closely with Upperline Plus' nurse practitioners and central interdisciplinary care team to provide high quality comprehensive care. In partnership with the Population Health and Operations teams, the VBC Medical Director will be accountable for the strategic design, improvement and implementation of critical value-based care initiatives and programs.

The Medical Director, VBC is a critical leader within Upperline and requires physicians with strong leadership, exceptional relationship building and communication skills, analytical capabilities and a desire to innovate, drive change and deliver results. Successful candidates will have experience working both on the clinical and business side of value-based care and will be present in the region.  As Upperline expands, this individual will be able to explore expansion of scope into specific care programs and/or larger market roles in operations or population health.

What You’ll Do

• Oversee the care management and medical management of the Upperline Plus patients being seen by Upperline’s Nurse Practitioners in the in the market or region
• Serve as the VBC clinical leader in a dyad partnership with the Regional VP of Operations
• Responsible for supervising medical management of patients in the region including clinical quality review of providers and serving as the collaborating physician for APPs in the region (as necessary based on state law)
• Accountable for value-based care outcomes (e.g., ADK, total cost of care), medical management, care management, utilization management, and quality improvement tools and processes in the region
• Manage and drive value-based care initiatives with APPs and doctors ensuring positive impact on patient outcomes
• Analyze population health data and identify gaps and develop solutions to improve delivery of care, decrease hospitalizations and reduce medical costs
• Ensure the region is meeting VBC operations metrics such as: addressing Quality gaps, accurate documentation, patient engagement and retention
• Design, implement and manage new value-based care programs and service lines in collaboration with population health and operations teams
• Conduct interdisciplinary team meetings to discuss management of the most complex patients (including high cost and high-risk patients)
• Establish and maintain relationships with VBC team, specialists, and PCPs in the region; educate on Upperline Plus program and advocate for collaborative partnerships benefiting patients
• Support onboarding and training of new providers and provide onsite and virtual clinical coaching and feedback with a focus on ensuring consistency and continuous improvement of managing patients more efficiently
• Educate providers on value-based care metrics and best practices and foster a culture that prioritizes accountability around outcomes-based performance
• Build relationships in the region and identify best partners (e.g., other specialists, home health agencies, hospitals) for Upperline to send referrals when needed 
• Develop clinical compliance guidelines and protocols

Experience and Qualifications

• Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.)
• Board certified in Internal Medicine, Family Medicine, Preventative Medicine, or Geriatrics
• Active license in Kentucky and willing to pursue multi-state licensure if needed
• Fellowship training in Geriatrics and/or other advanced degrees (e.g., M.B.A., M.P.H., M.H.A.) valued but not required
• ~ 5 years of outpatient practice experience
• Clinical leadership experience in a VBC or Population Health company 
• Experience with managed care and familiarity with payer-provider collaboration
• Owned or been part of creating, improving, and/or implementing clinical processes, protocols, or evidence-based guidelines
• Experience or exposure to rolling out and/ or managing VBC programs (e.g. Transitional Care Management, Complex Care Management, ED Diversion, Advanced Care Planning, High Risk Patient Outreach)
• Talent for synthesizing information and solving complex problems; can independently translate high-level goals into actionable plans
• Proven leadership skills and servant leadership mentality with a passion for people and culture
• Ability to communicate, collaborate and work effectively with staff, providers, and organizational leaders
• Self-starter with a bias for action orientation; demonstrates a service excellence mindset
• Exceptional organizational and project management skills and the ability to prioritize and multi-task autonomously
• Comfortable working in Excel; able to analyze data and present findings
• Must be willing and able to routinely visit clinics and providers within the region; Residing in the market is strongly preferred       

 

BENEFITS

Comprehensive benefit options include medical, dental and vision, 401K, PTO and parental leave.

COMPENSATION

Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience.

 

Job Type: Full-time