Physician Family Practice-Without OB - Competitive ...

Job DescriptionTo be considered for an interview, please make sure your application is full in line with the job specs as found below.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. Job DescriptionThe 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 forAdministrative oversight and outcomes determined by the Clinical / Operational Leadership of the MarketSpending 60-80% 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 CareCreate profit improvement initiativesDesign operational implementationsContribute 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 protocolsAssisting with panel managementProviding direct education to clinicians around clinical protocols / diseaseprevalence / appropriate levels of clinical quality careProviding guidance to individual clinicians about patient terminations, incollaboration with ComplianceSupporting clinicians with schedule templates, coverage, daily issuesManaging behavioral concerns of supervised staffAssisting with PTO ManagementAssisting with CME time and reimbursement requestsAssisting with completion of performance reviewsAssisting in resolution of inquiries, requests, and complaints from clinical staffAssisting in organizing team building activitiesAssisting in resolution of inquiries, requests, and complaints from patientsOngoing chart review / audit of clinical staff to ensure quality care and identifying opportunities for education/coachingIdentifying trends and areas of opportunity in pharmacy utilization (pharmacy management) to impact Part D per Member per Month (PMPM) costs while maintaining high quality careOptimizing network; preferred network specialists - contributing to the identification of preferred network specialists to optimized delivery of care for ongoing maintenance / cost saving opportunitiesMaking decisions related to the identification and mitigation of complex technical and operational problems within clinics/centersManaging financial / operational performance of their assigned clinics to ensure successParticipating in provider committees (i.e. Technology Governance, EMR Optimization, etc.) and attending meetings regularlyParticipating in Shared Service Strategy MeetingsParticipating in quality improvement programs, population health programs, continuing education, and other patient care programs established by clinical requirementsAssisting in recruiting and interviewing of potential clinical staffParticipating in patient retention and marketing activities as requiredServing as a community representative in the media and press activities Other duties as directed by the Market CMOMaintaining confidentiality of all patient information according to both state and federalguidelines and regulationsMaintaining medical history and medical recordsOrdering studies, tests and ancillary servicesParticipating as a back-up on-call physicianPrescribing medical treatment and clinical drugs to patientsReferring patients to specialists as needed Required QualificationsMD/DO8 or more years of technical experience2 or more years of project leadership experienceLicensure requirements of the state of jurisdictionGraduate of accredited MD or DO program of accredited universityPrefer Internal Medicine specialtyBoard Certification in Family Medicine, Internal Medicine or Geriatric MedicineThis 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 QualificationsActive and unrestricted DEA licenseMedicare Provider NumberMedicaid Provider NumberMinimum of three to five years directly applicable experience preferredExperience 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 indicatorsGood understanding of best practice coding and documentation in value based environmentLeveraging 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. xijylhu Understands the medical utilization implications of such programsCommunication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience. 

Created: 2026-03-07