Massachusetts Medicaid officials announced recently that 17 health care organizations statewide have signed up to participate in a major restructuring of the MassHealth program, shifting more members into networks of physicians, hospitals and other community-based providers working together as Accountable Care Organizations, or ACOs. Fallon Health was awarded 3 of these new ACO partnerships and will be an integral part of this new endeavor and with our experience providing integrated care through other government programs, we are perfectly positioned to provide outstanding care and excited about our new partnerships and growth potential.
To support this highly visible business initiative Fallon Health is looking for a new Medical Director. This is fantastic opportunity for an innovative physician leader interested in making a significant impact in the MassHealth Medicaid/ACO arena. The right individual will have a passion and track record of successful sustainable partnerships that brings together physicians, hospitals, insurers and other health care providers that work in harmony to provide integrated care with the goals of improving health outcomes and containing costs.
About FALLON HEALTH:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org
This is a newly created role reporting directly to Fallon’s Chief Medical Officer. Our new Medical Director for Medicaid will oversee the clinical care management of the ACO Medicaid populations; identify trends and opportunities and develop and implement solutions and initiatives to manage patient outcomes and TME successfully; and ensure quality of care to all Medicaid members and successful outcomes in all quality measures required by MassHealth and Massachusetts EOHHS.
You will establish close working relationships with the clinical leadership of our (3) new ACO partners. In addition you will ensure compliance with all regulatory and accreditation agencies and laws including but not limited to CMS, EOHHS, NCQA, and HIPAA pertaining to all clinical activities and interventions.
The Medical Director for Medicaid works collaboratively with the Executive Director of Medicaid to support activities necessary to provide service to our ACO partners and to EOHHS.