JOB SUMMARY:
The Regional Medical Director (RMD) provides strategic clinical leadership and oversight for multiple BoldAge PACE sites across a geographic area that can include several states, maintaining active medical licensure in each applicable state. Regional Medical Directors will be licensed in multiple Regions to allow for coverage for other RMD’s vacations and in emergency situations. Working in partnership with the Chief Clinical Officer, the RMD ensures BoldAge Pace consistently delivers exceptional participant outcomes, regulatory compliance and operational efficiency. The Regional Medical Director role combines direct participant care with a local panel of patients at the provider’s home office [BF2] with broader regional leadership responsibilities, including the ability to provide coverage for other regional locations including but not limited to fulfilling needs related to APP practice in an emergency or when state regulations require active patient practice. In addition to maintaining a clinical panel, the Regional Medical Director provides administrative leadership by overseeing the Regional Quality Assessment and Performance Improvement (QAPI) program, collaborating with national clinical leadership to develop and maintain medical policies, guidelines, standing order protocols, and ensuring the efficient use of resources to achieve program goals. This position provides direct guidance and supervision to primary care physicians, advanced practice providers and other providers as assigned.By fostering collaboration across physicians, advanced practice providers, interdisciplinary teams, andcommunity providers the RMD advances BoldAge’s mission to deliver participant-centered, high-quality care while positioning BoldAge PACE for growth and innovation.
ESSESNTIAL DUTIES AND RESPONSIBILITIES:
Clinical Leadership & Oversight
- Carry a panel of participants, providing direct care in region (center, home and facility setting), including, but not limited to, taking on-call shifts (national coverage), providing emergency coverage in the event of provider absence and interdisciplinary team (IDT) participation.
- Oversee and evaluate participant care delivery 24/7 through established clinical leadership structures.
- Ensure timely completion of participant assessments and individualized care plans in compliance with PACE requirements.
- Collaborate with site Medical Directors and interdisciplinary teams to ensure participant needs are met and outcomes optimized.
- Collaborate and participate in national Clinical Leadership Meetings (led by CCO), acting as the regional representative and expert. Provide regional expertise for national clinical and operational development and represent regional needs at the national level.
- Participating in OPPE/FPPE with national team and providing feedback, coaching and mentoring as needed to regions providers.
- Participates in national and regional interdisciplinary committees and teams as necessary.
- Serves as a role model in delivering high-quality, participant-centered care, ensuring alignment with best practices and BoldAge’s values.
Quality & Regulatory Compliance
- Lead regional QAPI activities, analyze performance data, and implement improvement plans.
- Maintain understanding of and compliance with national CMS, state and regional PACE clinical regulations, state licensing requirements, and accreditation standards.
- Oversee regional infection control programs, OSHA safety compliance, and public health guidelines.
- Performs regular chart audits and provides constructive feedback related to charting, coding and opportunities.
Staff Supervision & Development
- Recruit, orient, supervise, and evaluate physicians, advanced practice providers, and other providers as assigned.
- Provide coaching, mentorship, and performance feedback.
- Maintain in coordination with national leadership accurate job descriptions (HR) and policies, guidelines and standing orders (VP Clinical Ops), aligned with regional regulations and BoldAge PACE policies.
- Acts as collaborating physician to advanced practice providers as necessary and appropriate by local state regulations.
Operational & Financial Oversight
- Establish and oversee effective 24/7 on-call coverage systems in collaboration with site leaders.
- Monitor budgets, KPIs, and financial reports to ensure efficient resource utilization.
- Support accurate coding and documentation in collaboration with the coding team.
Community & External Engagement
- Represent BoldAge PACE at PACE associations, industry events, and with community providers.
- Maintain professional development through participation in training, continuing education, and networking.
Other Responsibilities
- Maintain participant confidentiality and comply with HIPAA standards.
- Performs all other duties as assigned to meet organizational needs.
EXPERIENCE EDUCATION AND CERTIFICATIONS:
- M.D. or D.O. with current medical license and the ability to obtain and maintain active licensure in all states in which BoldAge PACE operates. Must also hold current DEA registration and have the ability to obtain and maintain staff privileges at PACE-contracted agencies. Board certification in Internal Medicine or Family Practice required; advanced certification in Geriatrics preferred.
- Demonstrated experience in a managed care environment, collaborating with peers and other healthcare providers to address utilization management, quality management, performance improvement, pharmacy and therapeutics, peer review, credentialing, and physician leadership matters.
- Minimum of 3 years in a lead administrative role with responsibility for clinical oversight across multiple locations or programs.
- A minimum of 3 years’ experience working with frail and elderly populations in acute care, primary care, long-term care, or community-based settings.
PRE-EMPLOYMENT REQUIREMENTS:
- Must have reliable transportation, a valid driver's license, and the minimum state required liability auto insurance.
- Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact.
- Pass a comprehensive criminal background check that may include, but is not limited to, federal and state Medicare/Medicaid exclusion lists, criminal history, education verification, license verification, reference check, and drug screen.
