Regional Medical Director - Value Based Care

GENERAL STATEMENT OF DUTIES


The Regional Medical Director for musculoskeletal Value Based Care (VBC) provides physician leadership and clinical oversight for all MSK value-based care initiatives within an assigned region. This role partners closely with value-based care managers, operational leaders, network managers, and market clinicians to develop and execute clinical strategies that improve quality, outcomes, patient experience, and MSK total cost of care. The Regional Medical Director oversees a multidisciplinary clinical team and serves as a clinical liaison to clients and supports the effective deployment of digital and in-market clinical resources.


ESSENTIAL FUNCTIONS

Clinical Leadership & Strategy

• Work with Chief Medical Officer of Value Based Care (CMO of VBC) to implement VBC strategies to ensure high-quality, cost-effective care is being delivered.

• Provide regional physician leadership for value-based care programs

• Oversee clinical strategies aligned with organizational quality, utilization, and cost-management goals.

• Guide evidence-based clinical decision-making to optimize patient outcomes and performance against VBC metrics and targets.

Oversight of Clinical Resources

• Provide clinical oversight and direction for clinicians supporting value-based care initiatives.

• Collaborate with care managers, advanced practice providers, and other clinical team members to ensure coordinated, high-quality care delivery.

• Support deployment and execution of standardized care pathways, clinical protocols, and population health initiatives across the region.

Provider Engagement & Education

• Support development and dissemination of metrics to be used in performance-based incentive programs for MSK and PCP clinicians to optimize program performance

• Partner with VBC network managers to engage market MSK and PCP clinicians in understanding HOPCo's program expectations, incentive eligibility, clinical performance data, quality metrics, and utilization trends.

• Educate and support providers on improvement strategies, care redesign, and best practices in value-based care.

• Serve as a clinical advisor to regional physicians and practice leaders to drive adoption of VBC initiatives.

Data-Driven Improvement

• Review and interpret clinical, quality, and financial data to identify opportunities for improvement.

• Collaborate with analytics and operational teams to translate data insights into actionable clinical and operational strategies.

• Support continuous performance improvement through targeted interventions and clinician feedback.

• Lead regional initiatives to improve other quality measures such as HEDIS scores, Star Ratings, and other key VBC quality metrics

Client & Stakeholder Engagement

• Serve as a clinical expert in client-facing discussions.

• Communicate clinical strategy, performance, and improvement plans to internal and external stakeholders.

• Support contract performance reviews and strategic planning for value-based arrangements.

Governance & Compliance

• Lead Quality Committees in assigned regions, engaging local physician leadership in strategies to optimize program performance.

• Works with other medical directors and CMO in the development and implementation of clinical protocols and evidence-based pathways tailored to VBC performance (e.g., reducing avoidable ER visits, managing chronic conditions).

• Ensure clinical activities align with regulatory requirements, accreditation standards, and organizational policies.

• Promote a culture of quality, accountability, and patient-centered care across the region.

• Other duties as assigned

EDUCATION

• Medical Degree from accredited school as determined by either the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association Commission on Osteopathic College Accreditation (COCA) AND must have graduated from an accredited graduate medical education program (residency) as determined by the Accreditation Council for Graduate Medical Education (ACGME)

EXPERIENCE

• Minimum of ten years of experience as a practicing physician.

• Must have strong background in treating musculoskeletal conditions and care delivery.

• Must have at least 3 years in a leadership role within a VBC environment (ACO, Medicare Advantage, risk bearing health system or provider organization, payor, or Clinically Integrated Network) or role similar to a Chief Medical Officer.

KNOWLEDGE

• Knowledge of quality improvement philosophy, models, and processes within a healthcare organization.

• In-depth knowledge of quality management, patient safety, health information technology, and peer review to enhance physician performance and practice efficiency

• Applicant should have a deep understanding of VBC reimbursement models (population health, risk-based models, shared savings, global capitation).

• Knowledge of computerized statistical methods of gathering quality metrics.

• Knowledge of medical records and clinical care processes.

• Knowledge of quality initiatives and how to develop and implement strategic plans across a value-based care network.

• Should have proficiency of knowledge in health informatics and population health management

SKILLS

• Skill in effective application of quality measures, clinical guidelines, and process management initiatives.

• Applicants should exhibit strong emotional intelligence and the ability to influence clinicians who may not report to them directly

• Skill in consistently meeting quality requirements and educating providers and staff.

• Skill in using computer applications to effectively produce needed reports to identify trends.

• Skill in evaluation, analysis, and presentation of data to providers and committees.

• Skill in communicating effectively with all stakeholders across the medical ecosystem including but not limited to physicians, healthcare administrators/systems and insurers.

• High emotional quotient with a mature, self-confident demeanor that is effective and credible across all levels of the organization, including senior management, medical staff, healthcare administrators and insurers.

• High level of proficiency with analytic tools to display data for action-oriented results.

ABILITIES

• Proven ability to work cross-functionally in team environments to develop, evaluate, and execute best practice initiatives designed to promote excellence across the care continuum.

• Demonstrate ability to generate innovative ideas in health care delivery with ability to influence and acquire necessary resources across departments.

• Ability to work effectively with providers, healthcare systems/administrators, health insurers, management, and staff.

• Ability to synthesize quality data and implement programs to provide high quality value-based care.

• Ability to mentor and train staff in the clinic environment.

• Ability to communicate verbally and in writing to various levels of staff.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.

• Some travel as needed for additional markets.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.

• Some bending and stretching are required.

• Manual dexterity using a calculator and computer keyboard.

ORGANIZATIONAL REQUIREMENTS

• HOPCo Mission, Vision, and Values must be read and signed.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.

Equal Opportunity Employer
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