SIMED is currently seeking a Chief of Population Health to join our Population Health Management team.
The Chief of Population Health will be responsible for developing contracting strategy with the SIMED Chief Executive Officer, negotiating contracts, and overseeing managed care Population Health initiatives. The Chief of Population Health will report directly to the CEO, and work in conjunction with the Chief Operating Officer for implementation of initiatives.
SIMED is a physician owned, multi-specialty group serving a diverse patient population in the North Central Florida community. Our team of 75 physicians strives to provide quality healthcare to the communities we serve.
The duties and responsibilities for this position include, but are not limited to:
Analyze and oversee the Medicare value-based contracts to realize shared surplus and avoid deficits (MSSP, MAPs, etc.)
Negotiate value-based contracts in all lines of business (Commercial, Medicaid, Medicare) as appropriate
As new providers or groups join SIMED, evaluate contracting opportunities and implement strategies to maximize gain
Maintain relationships with all existing third-party payers and networks; resolve issues as they arise; and re-negotiate contracts when appropriate
Work with Administration and Operations team to ensure operational policies and procedures, and contracting initiatives are aligned.
Work with the VP of Finance and Director of A/R to ensure payers are paying correctly; resolve issues as they arise; and determine (on an ongoing basis) if opportunities exist to improve revenue
Implement coding initiatives, and guide to improve documentation and coding for complex conditions and CPT accuracy
Fully utilize the data analytics to identify opportunities, and implement programs, that will reduce healthcare beneficiary costs, and maintain or improve our quality metrics within our value-based contracts
As new contracting or network opportunities arise: review the contract language, negotiate changes, and analyze the financial impact and present issues to the CEO. Make every effort to bring negotiations to a successful conclusion while protecting SIMED’s interests
Assist SIMED leadership in developing MSO contracts and relationships with external-to-SIMED providers as aligns with SIMED’s strategy
Assist with evaluating staffing needs, recruiting, hiring, evaluation, training, development, discipline, and/or termination of Population Health staff
Participate in Population Health education, training, evaluation of performance, and feedback to management, physicians and advanced care practitioners
Participate in Population Health education, training, evaluation of performance, and feedback to non-SIMED providers participating in SIMED population health plans
Coordinate in conjunction with Population Health data analytics vendor the required report generation and archiving of reports
Southeastern Integrated Medical (SIMED for short) is a 70+ multi-specialty physician group serving the healthcare needs of patients throughout North Central Florida. SIMED combines primary care physicians, specialists, diagnostic and therapeutic services, plus 400 dedicated and skilled staff members, in an integrated team-approach to provide the best possible medical treatment for area residents ...and families.
Established in 1986 -- with offices in Gainesville, Ocala, Lady Lake (The Villages), Chiefland, Lake City, and McIntosh -- SIMED has a proud tradition of offering convenient, affordable, quality health care in the following specialty areas:
Primary Care (Family Medicine, Internal Medicine & Geriatric Medicine)
Allergy & Asthma
Gynecology / Women's Health
Pain Management - Interventional
Physical Medicine & Rehabilitation
Spine & Neurosurgery
Urgent Care / Occupational Medicine