Remote Hcc Risk Adjustment Coding Jobs in Florida

Monogram Health is seeking a mission-driven Market Physician Executive (MPE) to lead its in-home multi-specialty polychronic care model within an assigned market. This role involves overseeing daily clinical and business operations, providing direct and indirect patient care, and ensuring exceptional outcomes through evidence-based clinical pathways. The MPE will contribute to the development and oversight of clinical strategies, policies, and programs to improve patient health outcomes.

Practice Info

• Lead an in-home multi-specialty polychronic care model in an assigned market.
• Each market is comprised of 5-10 territories led by local advanced practice providers (APP), registered nurses (RN), licensed clinical social workers (LCSW), and pharmacists.
• Collaborate with Monogram Health's Multi-Specialty Platform to leverage employed specialists to deliver in-home specialty care.
• Deploy a proven risk-based model to ensure health equity and health equality leveraging proprietary next generation AI algorithms.
• Focus on improving patient experience, population health outcomes, provider satisfaction, and lowering costs.
• Report to the Regional Vice President.

Responsibilities

• Lead daily high-risk and concurrent review rounds.
• Directly supervise front-line clinical and operations team members, including regular shadowing/ride-alongs in the field.
• Oversee and delegate operational responsibility to the Market Manager for daily operations such as patient engagement, scheduling, administrative oversight, strategic implementations, and P&L management.
• Collaborate with Market Leadership to develop and maintain a market culture of clinical excellence, adaptability to change, and patient outcome ownership.
• Regularly assess and present market performance and outcomes to Executive and Senior Leaders.
• Provide direct and indirect patient care, including diagnosis and treatment of acute and chronic diseases.
• Engage with patients on treatment plans, community provider collaboration, and direct evidence-based care pathways.
• Conduct Peer to Peer consults with community, facility, and health plan partners.
• Order labs, referrals, and complete actions to drive patient outcomes, close care gaps, and Clinical Intervention closure.
• Provide clinical guidance and direction to Market teams to drive Population Health Management activities.
• Collaborate with Medical Economics, Finance, and other stakeholders to root cause and action against utilization trends impacting care and outcomes.
• Present and guide population health strategies in clinical and operational meetings.
• Conduct patient reviews to target high utilizers, high risk, and high opportunity patients and patient cohorts.
• Participate in Monogram On-Call rotation, which will vary; e.g., 7 days on call minimum once/quarter.
• Provide coverage for other MPEs during PTO or vacancy, as needed.

Compensation

• Competitive compensation
• 401k with employer match

Benefits

• Medical, dental, and vision insurance
• Employee assistance program
• Employer-paid and voluntary life insurance
• Disability insurance
• Health and flexible spending accounts
• Financial wellness resources
• Paid holidays
• Flexible vacation time/PSSL
• Paid parental leave
• Work life assistance resources
• Physical wellness perks
• Mental health support
• Employee referral program
• BenefitHub for employee discounts

Shift & Schedule

• Participate in Monogram On-Call rotation which will vary; e.g. 7 days on call minimum once/quarter.

Requirements

• Current state medical license without restrictions to practice and free of sanctions from Medicaid or Medicare.
• Willingness to become licensed in multiple states.
• MD or DO degree from an accredited medical school.
• BC or BE in an ACGME approved specialty such as Nephrology, Internal Medicine, Family Practice, Emergency Medicine, Critical Care, Cardiology, Endocrinology, Hepatology, or Geriatrics.
• Active, unrestricted state medical license required in each state within the market, and ability to obtain additional states as needed.
• This position will be remote within the designated market with occasional in-home patient treatment visits and occasional domestic travel.
• Demonstrated experience applying evidence-based clinical criteria.
• Experience in multispecialty, geriatrics, and/or value-based care.
• Advanced management and communication skills.
• Experience with high need Medicare Advantage and managed Medicaid populations.
• Experience with NCQA, HEDIS, Medicaid, Medicare, quality improvement, medical utilization management, and risk adjustment.