Based in the San Antonio, TX, Regional Contact Centre (RCC), the TOP Medical Director – LAC RCC is responsible for and provides clear leadership in the delivery of professional, quality and effective medical assistance and managed care services to beneficiaries of the TRICARE Overseas Program (TOP) to the highest standards across the Latin America-Canada region (and other locations as directed.
Qualifications
- Must have graduated with a degree in medicine (MD or DO or equivalent)
- Unrestricted license to practice medicine; BC/BE in specialty
- Leadership experience in managing people/teams
- Ability to obtain ADP II clearance after accepting a position
- 10 years plus post-graduation clinical medicine experience; experience in Coordinating Doctor roles, Family, Emergency, Internal Medicine, or ICU background preferred
- Military health care system experience preferred
- Experience in managing/coordinating international evacuations a distinct advantage
- Team and performance management experience at a senior level
- Client account management experience
- Business acumen
- Computer literate
- English; Spanish an advantage but not essential
Key Responsibilities:
- Ensure that the operational delivery of TOP medical services and patient care across the region coordinated by the medical team meets the appropriate standard of medical quality in accordance with the TOP Clinical Quality Medical Plan (CQMP), DHA service level expectations, and Assistance Centre, and Medical Transportation Standards.
- Maintain direct oversight of all TRICARE Prime Remote regional clinical operations and all CONUS-based inpatient management for TOP beneficiaries
- Support RCC “Follow the Sun” principles and practices
- At an operational level, the Medical Director is responsible for delivering quality medical management of cases, medically appropriate case management direction, and oversight in accordance with Intl.SOS quality standards and medical/operational protocols, ensuring a “hands-on” medical supervision of cases, namely:
- Take MD escalations from the Medical Team, ranging from routine care through to urgent/emergent cases including inpatient admissions and medical transportation cases
- Provide MD recommendations for all such escalations and clearly document these recommendations in CRM (electronic medical record).
- Chair weekday morning transmission and afternoon hot handover meetings in order to provide medical case direction
- Provide medical case direction in medical transportation cases
- Ensure adherence to the TOP Medical Transportation SOP and checklists, and International SOS Standards in Medical Transportation
- Assist in the achievement of contractual KPIs
- Assist in the maintenance and improvement of the TOP Medical Transportation SOP and checklists
Quality Assurance
- In conjunction with the TOP Clinical Quality team, be responsible for quality assurance in regard to the provision of all TOP medical services delivered by the TOP RCC for the region, including adherence to client quality plan indices (in particular the CQMP), case audit and review service recovery, assessment of near misses, grievances, Potential Quality Incidents (PQIs) and Quality Incidents (QIs). The undertaking of Corrective Action Plans and a structured implementation of measures to further enhance the delivery of services as a result.
- Drive the quality assurance initiatives and processes, serving as the lead for quality assurance standards for the medical team covering TRICARE, with a focus on customer and client satisfaction and tracking of the medical service delivery.
- Review and analyze medical cases escalated for quality review and address any issues accordingly. This includes involvement in periodic medical case reviews, satisfaction surveys/complaints reviews, TAO quality case quality meetings, and utilization review escalations.
- Provide timely feedback and any applicable coaching or remedial training with the CNs
- Provide clinical guidance and oversight related to Provider quality matters through documented grievances potential quality incidents (PQI) or quality incidents (QI) ensuring investigations are conducted based on standard protocols.
TAO Liaison
- Develop close and constructive working relationships with the Tricare Area Office Medical Director, nurse case managers, and executives to ensure that there is open and constructive communication with respect to medical delivery expectations and resolution of issues that may arise with respect to TOP medical service delivery in the region.
- Engage with the Military Treatment Facility (MTF) Commanders in the region to ensure the TOP deliverables are achieved in an effective, efficient manner in accordance with the TOP contract requirements.
- Work in conjunction with other TOP colleagues in cultivating these relationships
- Support/attend meetings or conferences virtually or in person as required (such as TRICARE Point-of-Contact training)
TOP Provider Network
- Work closely with the TOP Network teams and the Head of Clinical Quality to maintain and develop the TOP provider network in the region.
- Support provider education during site visits and ongoing provider education initiatives as required
Management and Administration
- Facilitate effective positive teamwork and clear channels of communication both internally and externally.
- Set clear standards, action plans, and yearly performance appraisals for functional reports.
- Input and play an active role in overseeing medical staff succession planning and development programs.
Other/additional Responsibilities
- Assist with overseas screening requests from TAO-LAC
- Assist in training and teaching of the Medical Team
- Provide “locum” coverage for other TOP MDs (may involve international travel)
- Undertake project work or other reasonable duties as required
- Work within and promote all International SOS’s policies, procedures, and corporate values.
- Ensure that patient information is managed and stored appropriately and adheres to privacy regulations and procedures.
- Maintain up-to-date medical license and passport.
Required Skills and Knowledge
- Demonstrated confident decision-making in acute clinical case management
- Strong leadership and staff management skills within a matrix organization
- Ability to manage multiple line manager reports in a structured and consistent manner
- Effective both strategically and at an operational level
- Effectively balance medical needs with commercial considerations
- Proactive, solutions and client-focused
- Negotiation skills
- Time management
- Aptitude for working in a commercial organization
- Cultural awareness
- Interpersonal and rapport building
- Professional presentation and communication
- Flexibility to work rostered on call pattern and travel
Required Competencies
- Deciding & Initiating Action: Makes prompt, clear decisions which may involve tough choices or considered risks; Takes responsibility for actions, projects, and people; Takes initiative, acts with confidence, and works under own direction; Initiates and generates activity.
- Leading & Supervising: Provides others with a clear direction; Sets appropriate standards of behavior; Delegates work appropriately and fairly; motivates and empowers others; Provides staff with development opportunities and coaching; Recruits staff of a high caliber.
- Relating & Networking: Establishes good relationships with customers and staff; Builds wide and effective networks of contacts inside and outside the organization; relates well to people at all levels; Manages conflict; Uses humor appropriately to enhance relationships with others.
- Persuading & Influencing: Makes a strong personal impression on others; Gains clear agreement and commitment from others by persuading, convincing, and negotiating; Promotes ideas on behalf of self or others; Makes effective use of political processes to influence and persuade others.
- Presenting & Communicating Information: Speaks clearly and fluently; Expresses opinions, information, and key points of an argument clearly; Makes presentations and undertakes public speaking with skill and confidence; Responds quickly to the needs of an audience and to their reactions and feedback; Projects credibility.
- Delivering Results & Meeting Customer Expectations: Focuses on customer needs and satisfaction; Sets high standards for quality and quantity; Monitors and maintains quality and productivity; Works in a systematic, methodical, and orderly way; Consistently achieves project goals
- Coping with Pressure & Setbacks: Works productively in a pressurized environment; Keeps emotions under control during difficult situations; Balances the demands of a work life and a personal life; Maintains a positive outlook at work; Handles criticism well and learns from it.
Travel / Rotation Requirements
- Travel as required regionally for meetings, conferences, and site visits and participate in annual audits in the US as needed.
Compensation | Min:200,000 Max: 265,000
Pay range is based on several factors and may vary in addition to a full range of medical, financial, and/or other benefits. Final salary and offer will be determined by the applicant’s background, experience, skills, internal equity, and alignment with geographical market data.
International SOS Government Medical Services is an equal opportunity employer and does not discriminate against employees or job applicants on the basis of race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state and local laws.
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