HealthPlanOne (HPONE) is a rapidly growing, best in class member acquisition Company in the Medicare and individual health insurance markets.  Through our digital marketing, proprietary technology and call center operations in Tampa, FL, and Phoenix, AZ, HPONE assists health plans acquire incremental membership on a very cost effective basis.  Based in Trumbull, CT, HPO is a funded by Peloton Equity, LLC located in Greenwich, CT, focusing on growth capital investments in the healthcare industry. We are recipients of several industry awards including the Inc.500/5000 list of fastest growing private companies in America, 2010-2014 Marcum Tech Top 40 as well as the 2012 - 2014 Deloitte Technology Fast 500. 
 
OPPORTUNITY
To continue this revenue growth, the Company has launched Stars Solutions, a new business unit, to aid health plans in closing care gaps and improving quality of care, thereby increasing their CMS Stars Ratings. The Stars Solutions program consists of three interlocking components: Data Analytics, Targeted Outreach, and Outbound Intelligence. We are expanding our team to drive the rapid growth of this new business unit. Consulting to the VP, Stars Solutions, the Medicare Medical Director Consultant is responsible for advising on the clinical aspects of program design. The position requires 10 to 15 hours a week.
 
KEY RESPONSIBILITIES

• Establish the range and type of appropriate patient care for each Stars measure
• Identify patient objections and obstacles to care for each Stars measure
• Advise on the process flow and script development for call center targeted patient and physician outreach campaigns, on a Stars measure by measure basis
• Ensure that patient rights respected during targeted outbound campaigns
• Monitor Stars Solutions program conformance with legal and regulatory requirements
• Advise on creation of performance targets for specific Stars measures, for each individual client
• Consult with business development team on identifying appropriate medical decision makers for potential clients
• Attend select sales calls for prospective and existing clients
• Identify and recommend companies in medical field for business partnership to enhance program design

REQUIREMENTS

• Knowledge of, and experience in, CMS 5 Star Rating system for health plans is required, from a strategic level in terms of how the program affects health plans and patient care down to a detailed level of clinical care required for each measure
• Board Certification in a specialty recognized by the American Board of Medical Specialties
• At least 5 years of clinical practice experience
• At least 5 years of experience working as a Medical Director in a (managed care) health plan; Medicare managed care experience preferred
• Outstanding interpersonal and written communication skills
• Client interface skills, both as part of a larger team presentation and in small working sessions
• An entrepreneurial spirit and ability to work under pressure of multiple projects and deadlines
• Location in the Tri-State (NY, CT, NJ) area strongly preferred

 
Equal opportunity:
HealthPlanOne (HPONE) is an equal opportunity employer, committed to employment equity throughout all levels of the organization.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.  We welcome and encourage diversity in the workplace.  HealthPlanOne(HPONE) requires the necessary drug testing and background checks to maintain a safe, drug-free work environment.